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Individual

DR. ALLEN G GERBERDING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1515 W WALNUT ST, JACKSONVILLE, IL 62650-1150
(217) 243-6454
(217) 243-1388
Mailing address
1515 W WALNUT ST, JACKSONVILLE, IL 62650-1157
(217) 243-6454
(217) 243-1388

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036057587
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036057587
IL
01
06900103
BCBS
IL
Enumeration date
02/03/2006
Last updated
06/13/2011
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