Cardenas, Gabriel

Cardenas, Gabriel is an sole proprietor health care provider with primary practice located at 6810 State Route 162 Suite 20, Maryville IL 62062-8587. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Cardenas, Gabriel can be contacted via phone (618) 288-2835.

Contact Information

Primary practice address
6810 State Route 162 Suite 20 Maryville IL 62062-8587
Phone: (618) 288-2835
Fax: (618) 288-6162
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 2010021578 Missouri
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 016.005608 Illinois

Profile Details

NPI number 1043521719
LBN Legal business name Cardenas, Gabriel
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2010
Last updated Nov 17th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043521719 NPPES
Illinois Other F100153987 MEDICARE GROUP PTAN

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