Individual
MICHAEL D. GILBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
324 ROXBURY RD, ROCKFORD, IL 61107-5090
(815) 381-7431
(815) 381-7498
Mailing address
PO BOX 735263, CHICAGO, IL 60673-5263
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00271757
RR MEDICARE
IL
Enumeration date
08/20/2006
Last updated
08/21/2023
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