Healthcare Provider Details

I. General information

NPI: 1215924212
Provider Name (Legal Business Name): LOUISA K GEHLMANN MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 OAK BROOK CENTER MALL STE 410
OAK BROOK IL
60523-1806
US

IV. Provider business mailing address

120 OAK BROOK CENTER MALL STE 410
OAK BROOK IL
60523-1806
US

V. Phone/Fax

Practice location:
  • Phone: 630-574-5860
  • Fax: 630-574-5866
Mailing address:
  • Phone: 630-574-5860
  • Fax: 630-574-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: LOUISA K GEHLMANN
Title or Position: OWNER
Credential: MD
Phone: 630-574-5860