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General NPI Number Information
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NPI Number | 1447781992
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Entity Type | Individual
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Provider Name | ITAMAR YAAKOV GNATT M.D
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Gender | Male
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Dates
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Enumeration Date | 03/27/2017
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 945 N 12TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53233-1305
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Country | US
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Telephone | 414-219-2000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 735044
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City | CHICAGO
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State | IL
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Zip | 60673-5044
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Country | US
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Telephone | 800-326-2250
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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 | 207PE0005X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
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License Number | 70439-20
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 26680
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 70439
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License Number State | WI
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Taxonomy #4
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 26680
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License Number State | NV
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