Individual
LAURENCE F GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 S GREENLEAF ST, STE A, GURNEE, IL 60031-3370
(847) 856-2525
(847) 856-1969
Mailing address
1 S GREENLEAF ST, STE A, GURNEE, IL 60031-3370
(847) 856-2525
(847) 856-1969
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036101520
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101520
—
IL
Enumeration date
11/09/2005
Last updated
06/28/2010
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