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General NPI Number Information
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NPI Number | 1093703365
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Entity Type | Individual
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Provider Name | GERTY JEAN-LOUIS M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2005
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Last Update Date | 08/12/2022
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Provider Practice Location Address
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Address Line | 5301 DEMPSTER ST SUITE 205
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City | SKOKIE
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State | IL
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Zip | 60077-1846
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Country | US
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Telephone | 847-470-9911
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Fax |
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Provider Business Mailing Address
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Address Line | 5301 DEMPSTER ST SUITE 205
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City | SKOKIE
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State | IL
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Zip | 60077-1846
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Country | US
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Telephone | 847-470-9911
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 74280
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9102677
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 74280
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License Number State | GA
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