Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1000-25 | WI |
N | 222Z00000X | Podiatrist | 1000-25 | WI |
N | 213EP1101X | Primary Podiatric Medicine | 016005330 | IL |
Y | 213ES0103X | Foot & Ankle Surgery | 16005330 | IL |
NPI | 1134338809 |
---|---|
Provider Name | Dr. Andrea Eve Gillio |
First Address | Chicago, IL 60634-4312 |
Second Address | Chicago, IL 60634-4312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
016005330 | (05) | IL |
1134338809 | (05) | IA |
1134338809 | (05) | WI |
P01788700 | RAILROAD MEDICARE (01) | IA |