Gaynor, Ellen
Gaynor, Ellen is an individual health care provider with primary practice located at 2160 S First Ave Luh - North Ent., Rm. 7604, Maywood IL 60153. She recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as her primary health care specialty. Gaynor, Ellen can be contacted via phone (708) 216-3304.Contact Information
Primary practice address
2160 S First Ave Luh - North Ent., Rm. 7604
Maywood IL 60153
Phone: (708) 216-3304
Fax: (708) 216-1259
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hematology & Oncology | 207RH0003X | 36060577 | Illinois |
Profile Details
| NPI number | 1225015589 |
|---|---|
| LBN Legal business name | Gaynor, Ellen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2005 |
| Last updated | Sep 15th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225015589 | NPPES |
| Illinois | MEDICAID | 36060577 |
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