MEDICARE: DR. JOHN J. GASHKOFF M.D.

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	207L00000X	Anesthesiology Physician	036087991	IL
2	208VP0014X	Interventional Pain Medicine Physician	036087991	IL

General Provider Information

NPI Number	:	1356309694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN J. GASHKOFF M.D.

Provider Business Mailing Address
First Line	:	PO BOX 713260
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-1260
Country	:	US
Telephone Number	:	630-469-9200
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 SPALDING DR
Second Line	:	STE 400
City	:	NAPERVILLE
State	:	IL
Zip	:	60540-6508
Country	:	US
Telephone Number	:	630-967-6000
Fax Number	:

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	08/08/2023

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