Provider Demographics
NPI:1588054647
Name:BRANDON C. GIMBEL, M.D., LLC
Entity type:Organization
Organization Name:BRANDON C. GIMBEL, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:GIMBEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-892-7300
Mailing Address - Street 1:601 SKOKIE BLVD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062
Mailing Address - Country:US
Mailing Address - Phone:847-892-7300
Mailing Address - Fax:847-892-7301
Practice Address - Street 1:601 SKOKIE BLVD
Practice Address - Street 2:SUITE 1A
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062
Practice Address - Country:US
Practice Address - Phone:847-892-7300
Practice Address - Fax:847-892-7301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-28
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361317222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty