MEDICARE: MRS. MARGARET M GATLIN

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	344600000X	Taxi	G34557359962	IL

General Provider Information

NPI Number	:	1710356746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARGARET M GATLIN

Provider Business Mailing Address
First Line	:	18 LINCOLN ST
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-1026
Country	:	US
Telephone Number	:	224-800-6978
Fax Number	:	847-854-8248

Provider Business Practice Location Address
First Line	:	18 LINCOLN ST
Second Line	:
City	:	LAKE IN THE HILLS
State	:	IL
Zip	:	60156-1026
Country	:	US
Telephone Number	:	224-800-6978
Fax Number	:	847-854-8248

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

Provider Enumeration Date	:	09/21/2015
Last Update Date	:	09/21/2015

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