MEDICARE: GERSON H KAPLAN MD SC

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
1	2084P0800X	Psychiatry Physician		IL

General Provider Information

NPI Number	:	1164499257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GERSON H KAPLAN MD SC

Provider Business Mailing Address
First Line	:	111 N WABASH AVE
Second Line	:	STE 1119
City	:	CHICAGO
State	:	IL
Zip	:	60602-3128
Country	:	US
Telephone Number	:	312-782-0319
Fax Number	:	312-263-7636

Provider Business Practice Location Address
First Line	:	111 N WABASH AVE
Second Line	:	STE 1119
City	:	CHICAGO
State	:	IL
Zip	:	60602-3128
Country	:	US
Telephone Number	:	312-782-0319
Fax Number	:	312-263-7636

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GERSON HIRSH KAPLAN
Credential	:	MD
Telephone Number	:	312-782-0319

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	08/22/2020

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