MEDICARE: OAK PARK CONSULTANT

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		IL

General Provider Information

NPI Number	:	1356388185
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK PARK CONSULTANT

Provider Business Mailing Address
First Line	:	8135 N MILWAUKEE AVE
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-2828
Country	:	US
Telephone Number	:	847-967-1149
Fax Number	:	847-967-8594

Provider Business Practice Location Address
First Line	:	8135 N MILWAUKEE AVE
Second Line	:
City	:	NILES
State	:	IL
Zip	:	60714-2828
Country	:	US
Telephone Number	:	847-967-1149
Fax Number	:	847-967-8594

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RBERT L GAY III
Credential	:	M.D.
Telephone Number	:	847-967-1149

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2020

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Directions to “OAK PARK CONSULTANT ” Practice Location

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