Gavin, Patricia Maureen

Gavin, Patricia Maureen is an individual health care provider with primary practice located at 3249 Oak Park Ave , Berwyn IL 60402-3429. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Gavin, Patricia Maureen can be contacted via phone (708) 783-2696.

Contact Information

Primary practice address
3249 Oak Park Ave Berwyn IL 60402-3429
Phone: (708) 783-2696
Fax: (708) 783-5096
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01057193A Indiana
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 88544 Ohio
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X Illinois

Profile Details

NPI number 1659327195
LBN Legal business name Gavin, Patricia Maureen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Feb 14th, 2008 - about 17 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 1659327195 NPPES
Illinois MEDICAID 036065903 1
Illinois Other P00057215

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