Revivo, Gadi Asher
Revivo, Gadi Asher is an individual health care provider with primary practice located at 355 E Erie St , Chicago IL 60611-3167. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine. Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine is his primary health care specialty. Revivo, Gadi Asher can be contacted via phone (312) 238-1000.Contact Information
Primary practice address
355 E Erie St
Chicago IL 60611-3167
Phone: (312) 238-1000
Fax: (312) 238-1208
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 036-104471 | Illinois |
| Allopathic & Osteopathic Physicians / Pediatric Rehabilitation Medicine | 2081P0010X | 036-104471 | Illinois |
Profile Details
| NPI number | 1922179787 |
|---|---|
| LBN Legal business name | Revivo, Gadi Asher |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 13th, 2006 |
| Last updated | Jun 23rd, 2022 - about 4 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 | 1922179787 | NPPES |
| Illinois | MEDICAID | 036104471-1 |
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