MEDICARE: FELICIA GILLS

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	172A00000X	Driver

General Provider Information

NPI Number	:	1831528553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FELICIA GILLS

Provider Business Mailing Address
First Line	:	675 SHERMAN ST
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3343
Country	:	US
Telephone Number	:	630-293-7387
Fax Number	:	630-293-9161

Provider Business Practice Location Address
First Line	:	675 SHERMAN ST
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3343
Country	:	US
Telephone Number	:	630-293-7387
Fax Number	:	630-293-9161

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

Provider Enumeration Date	:	11/04/2013
Last Update Date	:	11/04/2013

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Directions to “ FELICIA GILLS ” Practice Location

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