Individual
DANIEL WILLIAM GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
1300 FRANKLIN AVE, POB SUITE #100, NORMAL, IL 61761-3592
(309) 268-3761
(309) 268-5620
Mailing address
1300 FRANKLIN AVE, POB SUITE #100, NORMAL, IL 61761-3592
(309) 268-3761
(309) 268-5620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125061941
IL
Other
Enumeration date
06/26/2012
Last updated
07/01/2012
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