Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 036053561 | IL |
NPI | 1316986599 |
---|---|
Provider Name | Richard P Gaskill |
First Address | Lincolnwood, IL 60712-1028 |
Second Address | Skokie, IL 60077-1057 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 16/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C42535 | (02) |