Healthcare Provider Details

I. General information

NPI: 1053609248
Provider Name (Legal Business Name): DAVID BENJAMIN GELBMANN D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2011
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1440 S MICHIGAN AVE
CHICAGO IL
60605-2822
US

IV. Provider business mailing address

1440 S MICHIGAN AVE
CHICAGO IL
60605-2822
US

V. Phone/Fax

Practice location:
  • Phone: 312-880-0067
  • Fax: 312-880-0071
Mailing address:
  • Phone: 312-880-0067
  • Fax: 312-880-0071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016.005601
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: