Gavino, Conchita G

Gavino, Conchita G is an individual health care provider with primary practice located at 860 Summit St Suite 254, Elgin IL 60120-4339. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Gavino, Conchita G can be contacted via phone (847) 695-8721.

Contact Information

Primary practice address
860 Summit St Suite 254 Elgin IL 60120-4339
Phone: (847) 695-8721
Fax: (847) 695-8755
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 3656444 Illinois

Profile Details

NPI number 1215961214
LBN Legal business name Gavino, Conchita G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Nov 30th, 2012 - about 12 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 1215961214 NPPES
Illinois MEDICAID 036056444

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