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General NPI Number Information
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NPI Number | 1588054647
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Entity Type | Organization
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Legal Business Name | BRANDON C. GIMBEL, M.D., LLC
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 601 SKOKIE BLVD SUITE 1A
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-892-7300
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Fax | 847-892-7301
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Provider Business Mailing Address
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Address Line | 601 SKOKIE BLVD SUITE 1A
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City | NORTHBROOK
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State | IL
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Zip | 60062
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Country | US
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Telephone | 847-892-7300
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Fax | 847-892-7301
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRANDON GIMBEL
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Credential | M.D.
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Telephone | 847-892-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036131722
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License Number State | IL
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