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General NPI Number Information
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NPI Number | 1093946766
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Entity Type | Organization
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Legal Business Name | GILL INCORPORATED
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Dates
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Enumeration Date | 07/29/2009
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Last Update Date | 07/29/2009
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Provider Practice Location Address
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Address Line | 11451 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60628-4901
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Country | US
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Telephone | 773-995-9600
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Fax | 773-995-9601
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Provider Business Mailing Address
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Address Line | 11451 S MICHIGAN AVE
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City | CHICAGO
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State | IL
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Zip | 60628-4901
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Country | US
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Telephone | 773-995-9600
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Fax | 773-995-9601
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Authorized Official
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Title or Position | COO
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Name | ANGELA JOHNEICE RATCLIFFE
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Credential |
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Telephone | 773-995-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 036120999
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License Number State | IL
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