Provider Demographics
NPI:1316986599
Name:GASKILL, RICHARD P (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:P
Last Name:GASKILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3926 W TOUHY AVE
Mailing Address - Street 2:# 372
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-1028
Mailing Address - Country:US
Mailing Address - Phone:847-730-7098
Mailing Address - Fax:847-674-0892
Practice Address - Street 1:9977 WOODS DR
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1057
Practice Address - Country:US
Practice Address - Phone:847-663-8420
Practice Address - Fax:847-663-1018
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2018-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036053561207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C42535Medicare UPIN
550580Medicare ID - Type Unspecified