Doctor Name: | PATRICK JOSEPH GAVIN |
NPI Number: | 1154719821 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | APN-BC |
License Number: | 209.011843 |
Business Practice Address: | 478 E Fawn Ln Palatine, IL - 600742361 |
Business Phone Number: | 7082756748 |
Business Fax Number: | |
Mailing Address: | 478 E Fawn Ln, PALATINE |
State: | IL |
Postal Code: | 600742361 |
Phone Number: | 7082756748 |
Fax Number: | |
NPI Enumeration Date: | 01/05/2015 |
NPI Last Update Date: | 01/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 209.011843 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |