MEDICARE: ROBERT GELLES D.P.M.

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	213E00000X	Podiatrist	016003361	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	363307387	OTHER	IL	TAX ID

General Provider Information

NPI Number	:	1902868607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT GELLES D.P.M.

Provider Business Mailing Address
First Line	:	7460 W COLLEGE DR
Second Line	:	SUITE 101
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1193
Country	:	US
Telephone Number	:	708-671-9030
Fax Number	:	708-671-9033

Provider Business Practice Location Address
First Line	:	7460 W COLLEGE DR
Second Line	:	SUITE 101
City	:	PALOS HEIGHTS
State	:	IL
Zip	:	60463-1193
Country	:	US
Telephone Number	:	708-671-9030
Fax Number	:	708-671-9033

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	01/18/2022

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Directions to “ ROBERT GELLES D.P.M.” Practice Location

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