Provider Demographics
NPI:1003179466
Name:MUNITZ, GILLIAN E (MD)
Entity Type:Individual
Prefix:DR
First Name:GILLIAN
Middle Name:E
Last Name:MUNITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 W HURON ST
Mailing Address - Street 2:UNIT 413
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3432
Mailing Address - Country:US
Mailing Address - Phone:312-404-0200
Mailing Address - Fax:
Practice Address - Street 1:520 W HURON ST
Practice Address - Street 2:UNIT 413
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3432
Practice Address - Country:US
Practice Address - Phone:312-404-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-20
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI64494207P00000X
IL125-060977207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine