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General NPI Number Information
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NPI Number | 1003830670
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Entity Type | Individual
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Provider Name | RHONDA YVETTE GANS M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4829 S COTTAGE GROVE AVE
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City | CHICAGO
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State | IL
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Zip | 60615-1600
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Country | US
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Telephone | 312-646-6620
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Fax | 773-624-5642
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Provider Business Mailing Address
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Address Line | 440 N MCCLURG CT APT 112
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City | CHICAGO
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State | IL
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Zip | 60611-4352
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036-085091
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License Number State | IL
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