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Individual

DR. SHEILLAH C GENTILE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1001 MAIN ST, SUITE 2E, DYER, IN 46311-1234
(219) 865-9160
(219) 865-9251
Mailing address
1001 MAIN ST, SUITE 2E, DYER, IN 46311-1234
(219) 865-9160
(219) 865-9251

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01050311A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01050311A
STATE LISCENSE
IN
01
90001143
BC BS OF IL
IL
Enumeration date
01/11/2007
Last updated
03/07/2023
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