Provider Demographics
NPI:1992976591
Name:GIMBEL, BRANDON CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:CHARLES
Last Name:GIMBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:333 SKOKIE BLVD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1613
Mailing Address - Country:US
Mailing Address - Phone:847-721-9665
Mailing Address - Fax:888-246-6973
Practice Address - Street 1:333 SKOKIE BLVD
Practice Address - Street 2:SUITE 114
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1613
Practice Address - Country:US
Practice Address - Phone:847-721-9665
Practice Address - Fax:888-246-6973
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2366312084P0800X
IL0361317222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry