Provider Demographics
NPI:1306047444
Name:KOSHGARIAN, GAIL M (CNP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:M
Last Name:KOSHGARIAN
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Gender:F
Credentials:CNP
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Mailing Address - Street 1:2650 RIDGE AVE
Mailing Address - Street 2:EVANSTON HOSPITAL
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-1718
Mailing Address - Country:US
Mailing Address - Phone:847-570-1206
Mailing Address - Fax:847-570-1248
Practice Address - Street 1:2050 PFINGSTEN RD
Practice Address - Street 2:ENH CENTER FOR HEALTHY AGING, STE 330
Practice Address - City:GLENVIEW
Practice Address - State:IL
Practice Address - Zip Code:60026-1324
Practice Address - Country:US
Practice Address - Phone:847-998-4100
Practice Address - Fax:847-998-1419
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health