Mingolelli, Gerald J

Mingolelli, Gerald J is an sole proprietor health care provider with primary practice located at 17850 Kedzie Ave 3200, Hazel Crest IL 60429-2058. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Mingolelli, Gerald J can be contacted via phone (708) 798-8112.

Contact Information

Primary practice address
17850 Kedzie Ave 3200 Hazel Crest IL 60429-2058
Fax: (708) 798-9016
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 036085438 Illinois

Profile Details

NPI number 1508863531
LBN Legal business name Mingolelli, Gerald J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 5th, 2005
Last updated Jan 3rd, 2013 - about 11 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 1508863531 NPPES
Illinois MEDICAID 036085438

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