MEDICARE: DR. JULIE A GILBERTSON D.O.

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	207Q00000X	Family Medicine Physician	036079589	IL

General Provider Information

NPI Number	:	1811993470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE A GILBERTSON D.O.

Provider Business Mailing Address
First Line	:	1329 N. WOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056
Country	:	US
Telephone Number	:	847-803-3040
Fax Number	:	847-803-0871

Provider Business Practice Location Address
First Line	:	1329 N. WOLF RD
Second Line	:
City	:	MOUNT PROSPECT
State	:	IL
Zip	:	60056
Country	:	US
Telephone Number	:	847-803-3040
Fax Number	:	847-803-0871

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	02/12/2021

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