Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | IL |
NPI | 1033101274 |
---|---|
Provider Name | Dr. Michelle S Gittler |
First Address | Westchester, IL 60154-7227 |
Second Address | Chicago, IL 60608-1858 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036-081827-3 | (05) | IL |
F39279 | (02) | IL |