Michael T. Gillam
Emergency Physician
2650 Ridge Ave Emergency Medicine Rm G909
Evanston
, Illinois 60201-1718
Michael T. Gillam
Emergency Physician
2650 Ridge Ave Emergency Medicine Rm G909
Evanston
, Illinois 60201-1718
(847) 733-5315
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About
Features
Specialties
- Emergency Physician
Languages spoken
- English
Location
First Address
- Michael T. Gillam
- 2650 Ridge Ave Evanston Hospital
- Evanston, IL
- Zip : 60201-1718
- Fax : (847) 733-5315
- Phone : (847) 570-1644
Second Address
- Michael T. Gillam
- 2650 Ridge Ave Emergency Medicine Rm G909
- Evanston, IL
- Zip : 60201-1718
- Fax : (847) 570-1223
- Phone : (847) 570-2114
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | IL |
National Provider Identifier
| NPI | 1013092188 |
|---|---|
| Provider Name | Michael T. Gillam |
| First Address | Evanston, IL 60201-1718 |
| Second Address | Evanston, IL 60201-1718 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| H03534 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.