Provider Demographics
NPI:1487716965
Name:GAO, QINGSHEN (MD)
Entity type:Individual
Prefix:
First Name:QINGSHEN
Middle Name:
Last Name:GAO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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 1:1001 UNIVERSITY PL
Practice Address - Street 2:SUITE 304
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3137
Practice Address - Country:US
Practice Address - Phone:224-364-7531
Practice Address - Fax:224-364-7402
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program