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Individual

ROBERT GASIOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11560 S KEDZIE AVE, SUITE 100, MERRIONETTE PARK, IL 60803-4517
(708) 371-3105
(708) 390-2105
Mailing address
11560 S KEDZIE AVE, SUITE 100, MERRIONETTE PARK, IL 60803-4517
(708) 371-3105
(708) 390-2105

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036041857
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
036041857
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01621208
BLUECROSSBLUESHIELD
IL
01
01621679
BCBS OF IL
IL
05
036041857
IL
01
060042342
RAILROAD MEDICARE COOK
IL
01
CD8033
RAILROAD MEDICARE GROUP PTAN NUMBER
IL
01
CG1672
RAILROAD MEDICARE GROUP PTAN NUMBER
IL
01
P00000362
RAILROAD MEDICARE KANKAKEE
IL
Enumeration date
12/21/2005
Last updated
11/07/2016
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