Individual
MICHAEL GERNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
834 N SEMINARY ST, SUITE 102, GALESBURG, IL 61401-2852
(309) 342-0194
(309) 342-9759
Mailing address
834 N SEMINARY ST, SUITE 102, GALESBURG, IL 61401-2852
(309) 342-0194
(309) 342-9759
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
36067279
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-0672791
—
IL
01
—
04815039
BLUE CROSS BLUE SHIELD
—
01
—
200029632
RAILROAD MEDICARE
—
Enumeration date
09/12/2005
Last updated
05/06/2008
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