Gage, Andrew Robert

Gage, Andrew Robert is an individual health care provider with primary practice located at 101 Coles Centre Dr , Mattoon IL 61938-9314. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Hospitalist. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Gage, Andrew Robert can be contacted via phone (217) 234-5110.

Contact Information

Primary practice address
101 Coles Centre Dr Mattoon IL 61938-9314
Phone: (217) 234-5110
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036102275 Illinois
Allopathic & Osteopathic Physicians / Hospitalist 208M00000X 036102275 Illinois

Profile Details

NPI number 1013931567
LBN Legal business name Gage, Andrew Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Mar 7th, 2023 - about 2 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 1013931567 NPPES
Illinois Other 336064010 ILLINOIS CONTROLLED SUBSTANCE LICENSE
Illinois Other 561920008 ILLINOIS CONTROLLED SUBSTANCE LICENSE
Illinois MEDICAID 036102275 ILLINOIS CONTROLLED SUBSTANCE LICENSE
Illinois MEDICAID 371391171003 ILLINOIS CONTROLLED SUBSTANCE LICENSE
Illinois Other 561920 ILLINOIS CONTROLLED SUBSTANCE LICENSE
Illinois Other 036102275 ILLINOIS CONTROLLED SUBSTANCE LICENSE

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