Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | DR.0060013 | CO |
N | 207X00000X | Orthopaedic Surgeon | ML60359487 | WA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 036150154 | IL |
NPI | 1174865208 |
---|---|
Provider Name | Romie Fritz Gibly |
First Address | Chicago, IL 60611-2991 |
Second Address | Chicago, IL 60611 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 23/08/2019 |