Healthcare Provider Details

I. General information

NPI: 1003563214
Provider Name (Legal Business Name): JULIE A. GEBHARDT APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2022
Last Update Date: 08/01/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 S. ROSELLE RD. 2ND FLOOR-PULMANARY
SCHAUMBURG IL
60193-2925
US

IV. Provider business mailing address

519 S. ROSELLE RD. 2ND FLOOR-PULMANARY
SCHAUMBURG IL
60193-2925
US

V. Phone/Fax

Practice location:
  • Phone: 847-618-4380
  • Fax: 847-618-0220
Mailing address:
  • Phone: 847-618-4380
  • Fax: 847-618-0220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209024836
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: