Healthcare Provider Details

I. General information

NPI: 1598414708
Provider Name (Legal Business Name): TREVOR GLENN GOHL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 W SALT CREEK LN STE 1300
ARLINGTON HEIGHTS IL
60005-1008
US

IV. Provider business mailing address

2650 RIDGE AVE # 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-0217
  • Fax: 847-618-0676
Mailing address:
  • Phone: 847-982-3175
  • Fax: 847-982-3394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036172370
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: