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Individual

DR. NATHAN C GILLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
525 KENOSHA ST, WALWORTH, WI 53184-9512
(262) 275-2101
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036143429
IL
207Q00000X
Family Medicine Physician
Primary
67683
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100070235
WI
Enumeration date
06/10/2013
Last updated
11/16/2023
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