Gerson, Carol

Gerson, Carol is an individual health care provider with primary practice located at 1031 Ashland Ave , River Forest IL 60305-1435. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, which is considered as her primary health care specialty. Gerson, Carol can be contacted via phone (708) 334-5160.

Contact Information

Primary practice address
1031 Ashland Ave River Forest IL 60305-1435
Phone: (708) 334-5160
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Otolaryngology 207YP0228X 036-057108 Illinois

Profile Details

NPI number 1356336168
LBN Legal business name Gerson, Carol
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Apr 25th, 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 1356336168 NPPES
Illinois Other 1627123 BCBS PROVIDER ID
Illinois MEDICAID 036057108 BCBS PROVIDER ID

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