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Individual

DR. GINA M. MIDMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1275 E BELVIDERE RD, SUITE 200, GRAYSLAKE, IL 60030-2082
(847) 918-1462
(847) 968-4311
Mailing address
PO BOX 745249, LOS ANGELES, CA 90074-5249
(541) 768-5111
(706) 653-1162

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
01073411A
IN
2085R0202X
Diagnostic Radiology Physician
Primary
036-131270
IL
2085R0202X
Diagnostic Radiology Physician
60516-20
WI
2085R0202X
Diagnostic Radiology Physician
MD433697
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1021935800002
PA
Enumeration date
04/12/2007
Last updated
05/01/2026
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