MEDICARE: KEVIN GILL D.N.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172P00000X	Naprapath	181.000379	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1164761102	OTHER	IL	NPPES

General Provider Information

NPI Number	:	1164761102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN GILL D.N.

Provider Business Mailing Address
First Line	:	500 N MICHIGAN AVE STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-3754
Country	:	US
Telephone Number	:	312-585-5587
Fax Number	:

Provider Business Practice Location Address
First Line	:	1130 S MICHIGAN AVE APT 503
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605
Country	:	US
Telephone Number	:	312-585-5587
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2013
Last Update Date	:	08/09/2018

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