Headley, Gillian M.

Headley, Gillian M. is an individual health care provider with primary practice located at 2400 N Rockton Ave , Rockford IL 61103-3655. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Headley, Gillian M. can be contacted via phone (815) 971-5000.

Contact Information

Primary practice address
2400 N Rockton Ave Rockford IL 61103-3655
Phone: (815) 971-5000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 22363 Wisconsin
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X 036-103485 Illinois

Profile Details

NPI number 1497865687
LBN Legal business name Headley, Gillian M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated May 25th, 2022 - 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 1497865687 NPPES
Illinois MEDICAID 036103485

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