Doctor Name: | GESIELE L MOCKABEE |
NPI Number: | 1265673545 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 19 E North St Danville, IL - 61832 |
Business Phone Number: | 2174429447 |
Business Fax Number: | 2174428761 |
Mailing Address: | 701 Chandler, DANVILLE |
State: | IL |
Postal Code: | 61832 |
Phone Number: | 2174310893 |
Fax Number: | 2174428761 |
NPI Enumeration Date: | 03/16/2009 |
NPI Last Update Date: | 03/16/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |