Individual
GILBERT N EGEKEZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5911 NORTHWEST HWY, #205, CRYSTAL LAKE, IL 60014-8065
(815) 477-7800
(815) 477-7812
Mailing address
5480 ALEXANDRIA DR, LAKE IN THE HILLS, IL 60156-6211
(815) 477-7800
(815) 477-7812
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036100558
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100558
—
IL
01
—
04532115
BLUE CROSS/SHIELD
IL
01
—
P00192277
RAIL ROAD MEDICARE
IL
Enumeration date
09/26/2006
Last updated
04/05/2012
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