| Michael M Gelbort Inc | |
|
2714 Caton Farm Rd Joliet IL 60435-1309 | |
| (815) 230-2262 | |
| Not Available |
| Full Name | Michael M Gelbort Inc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2714 Caton Farm Rd, Joliet, Illinois |
| Authorized Official Name and Position | Michael M Gelbort (OWNER) |
| Authorized Official Contact | 8152302262 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michael M Gelbort Inc 2714 Caton Farm Rd Joliet IL 60435-1309 Ph: (815) 230-2262 | Michael M Gelbort Inc 2714 Caton Farm Rd Joliet IL 60435-1309 Ph: (815) 230-2262 |
| NPI Number | 1083749451 |
|---|---|
| Provider Enumeration Date | 02/23/2007 |
| Last Update Date | 02/14/2014 |
| Medicare PECOS PAC ID | 8527089531 |
|---|---|
| Medicare Enrollment ID | O20051216000659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083749451 | NPI | - | NPPES |
| 9904511 | Other | IL | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 07100400 (Illinois) | Primary |
| Provider Name | Michael M Gelbort |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295805778 PECOS PAC ID: 9032103585 Enrollment ID: I20040408001212 |
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