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NPI Code Detail

MEDICARE: DR. SCOTT ALAN GERSHAN MD

MEDICARE: DR. SCOTT ALAN GERSHAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician036140712IL

General Provider Information

NPI Number : 1093005399
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT ALAN GERSHAN MD
Provider Business Mailing Address
First Line : 446 E ONTARIO ST STE 7-200
Second Line :
City : CHICAGO
State : IL
Zip : 60611-4418
Country : US
Telephone Number : 312-926-2323
Fax Number :
Provider Business Practice Location Address
First Line : 680 N LAKE SHORE DR STE 1000
Second Line :
City : CHICAGO
State : IL
Zip : 60611-8709
Country : US
Telephone Number : 312-695-2198
Fax Number : 312-695-6594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2011
Last Update Date : 08/20/2019

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Directions to “ DR. SCOTT ALAN GERSHAN MD” Practice Location

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