Individual
GINA GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
250 E SUPERIOR ST FL 16, CHICAGO, IL 60611-2914
(312) 472-3665
(312) 472-4223
Mailing address
250 E SUPERIOR ST FL 16, CHICAGO, IL 60611-2914
(312) 472-3665
(312) 472-4223
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004445
IL
363A00000X
Physician Assistant
3042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801145602
—
WI
Enumeration date
09/07/2012
Last updated
08/17/2023
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