MEDICARE: MICHAEL GASSER

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	208000000X	Pediatrics Physician	01088216A	IN

General Provider Information

NPI Number	:	1720514474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL GASSER

Provider Business Mailing Address
First Line	:	PO BOX 719094
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-9318
Country	:	US
Telephone Number	:	317-777-6435
Fax Number	:	317-777-6644

Provider Business Practice Location Address
First Line	:	705 RILEY HOSPITAL DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-5109
Country	:	US
Telephone Number	:	317-777-6935
Fax Number	:

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

Provider Enumeration Date	:	05/02/2017
Last Update Date	:	03/17/2026

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Directions to “ MICHAEL GASSER ” Practice Location

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