Gavino, Conchita G
Gavino, Conchita G is an individual health care provider with primary practice located at 860 Summit St Suite 254, Elgin IL 60120-4339. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Gavino, Conchita G can be contacted via phone (847) 695-8721.Contact Information
Primary practice address
860 Summit St Suite 254
Elgin IL 60120-4339
Phone: (847) 695-8721
Fax: (847) 695-8755
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 3656444 | Illinois |
Profile Details
| NPI number | 1215961214 |
|---|---|
| LBN Legal business name | Gavino, Conchita G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Nov 30th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1215961214 | NPPES |
| Illinois | MEDICAID | 036056444 |
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