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NPI 1841391232

NPI 1841391232 : NADER GILL D.M.D., M.S. : GURNEE, IL

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General NPI Number Information
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    NPI Number           |    1841391232
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    Entity Type          |    Individual 
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    Provider Name        |    NADER GILL D.M.D., M.S.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/26/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    5445 GRAND AVE SUITE 204
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    City                 |    GURNEE
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    State                |    IL
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    Zip                  |    60031-1725
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    Country              |    US
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    Telephone            |    847-263-7668
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4513 W BUTTERNUT LN 
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    City                 |    WAUKEGAN
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    State                |    IL
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    Zip                  |    60085-8639
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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        |    1223E0200X
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    Taxonomy Name        |    Endodontics
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    License Number       |    
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    License Number State |    IL
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