Individual
GEMILO RESABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 BAILEY LN, BENTON, IL 62812-1969
(618) 439-3161
(618) 439-7126
Mailing address
201 BAILEY LN, BENTON, IL 62812-1969
(618) 439-3161
(618) 439-7126
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036085111
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036085111002
—
IL
Enumeration date
06/19/2006
Last updated
02/01/2012
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