Provider Demographics
NPI:1992729263
Name:WEHRMANN, GINA R (MD)
Entity type:Individual
Prefix:DR
First Name:GINA
Middle Name:R
Last Name:WEHRMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 AUSTIN ST
Mailing Address - Street 2:#354 EAST TOWER
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-3454
Mailing Address - Country:US
Mailing Address - Phone:847-491-6890
Mailing Address - Fax:847-491-0274
Practice Address - Street 1:800 AUSTIN ST
Practice Address - Street 2:#354 EAST TOWER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-3454
Practice Address - Country:US
Practice Address - Phone:847-491-6890
Practice Address - Fax:847-491-0274
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036976244207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E62220Medicare UPIN
934370Medicare ID - Type Unspecified