Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036110068 | IL |
NPI | 1003863077 |
---|---|
Provider Name | David R Guelich |
First Address | Chicago, IL 60657-9269 |
Second Address | Chicago, IL 60657-9269 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036110068 | (05) | IL |
I54649 | (02) | |
P00361976 | RAILROAD MEDICARE (01) | IL |