Healthcare Provider Details

I. General information

NPI: 1902868607
Provider Name (Legal Business Name): ROBERT GELLES D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 01/18/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 W COLLEGE DR SUITE 101
PALOS HEIGHTS IL
60463-1193
US

IV. Provider business mailing address

7460 W COLLEGE DR SUITE 101
PALOS HEIGHTS IL
60463-1193
US

V. Phone/Fax

Practice location:
  • Phone: 708-671-9030
  • Fax: 708-671-9033
Mailing address:
  • Phone: 708-671-9030
  • Fax: 708-671-9033

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number016003361
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: