Provider Demographics
NPI:1225094436
Name:GILMAN, ALBERT F IV (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:F
Last Name:GILMAN
Suffix:IV
Gender:M
Credentials:MD
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Mailing Address - Street 1:2300 N EDWARD ST
Mailing Address - Street 2:GSBLL
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-4163
Mailing Address - Country:US
Mailing Address - Phone:217-876-2857
Mailing Address - Fax:217-876-2874
Practice Address - Street 1:1 MEMORIAL DR STE 300
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-6322
Practice Address - Country:US
Practice Address - Phone:217-876-5500
Practice Address - Fax:217-876-5505
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2021-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036098200208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG94790Medicare UPIN
IL036098200Medicaid
ILK15663Medicare ID - Type Unspecified