Provider Demographics
NPI:1215924212
Name:LOUISA K GEHLMANN MD SC
Entity type:Organization
Organization Name:LOUISA K GEHLMANN MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOUISA
Authorized Official - Middle Name:K
Authorized Official - Last Name:GEHLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-574-5860
Mailing Address - Street 1:120 OAK BROOK CENTER MALL
Mailing Address - Street 2:STE 410
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1806
Mailing Address - Country:US
Mailing Address - Phone:630-574-5860
Mailing Address - Fax:630-574-5866
Practice Address - Street 1:120 OAK BROOK CENTER MALL
Practice Address - Street 2:STE 410
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-1806
Practice Address - Country:US
Practice Address - Phone:630-574-5860
Practice Address - Fax:630-574-5866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0360505141Medicaid
IL0360505141Medicaid
IL617110Medicare ID - Type Unspecified