Individual
DR. MARK CHRISTOPHER GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1300 N ARLINGTON HEIGHTS RD STE 130, ITASCA, IL 60143-3128
(847) 871-4540
(847) 871-4597
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036078671
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078671
—
IL
01
—
399980
MEDICARE GROUP PTAN
—
Enumeration date
09/26/2006
Last updated
08/31/2023
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