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Individual

GAIL J GIZZO-WAITLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
25 N. WINFIELD, WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427
Mailing address
25 N WINFIELD RD, WINFIELD, IL 60190-1295
(630) 933-4700
(630) 933-4427

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036092533
IL
208M00000X
Hospitalist Physician
Primary
036092533
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036092533 2
IL
01
206147
MEDICARE PTAN (GROUP)
IL
01
206147242
MEDICARE PTAN (INDIVIDUAL)
IL
01
9919630
BCBS
IL
01
CA4748
MEDICARE RAILROAD (GROUP)
IL
01
P01258419
MEDICARE RAILROAD (INDIVIDUAL)
IL
Enumeration date
09/28/2005
Last updated
01/18/2018
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