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Individual

MEHDAT GABRIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
LOYOLA UNIVERSITY MEDICAL CENTER, MCGAW ENT., RM. 47, MAYWOOD, IL 60153
(708) 216-5221
(708) 216-0899
Mailing address
LOYOLA UNIVERSITY MEDICAL CENTER, MCGAW ENT., RM. 47, MAYWOOD, IL 60153
(708) 216-5221
(708) 216-0899

Taxonomy

Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
036-105453
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036-105453
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K24227
MEDICARE
IL
Enumeration date
11/07/2006
Last updated
05/07/2021
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