Provider Demographics
NPI:1235116591
Name:GIL, AMARYLLIS (MD)
Entity Type:Individual
Prefix:
First Name:AMARYLLIS
Middle Name:
Last Name:GIL
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 1:1200 S YORK RD
Mailing Address - Street 2:STE. 3280
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5626
Mailing Address - Country:US
Mailing Address - Phone:630-758-8640
Mailing Address - Fax:630-758-8642
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:STE. 3280
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-758-8640
Practice Address - Fax:630-758-8642
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36104085207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL36104085Medicaid
ILK07548Medicare ID - Type Unspecified
I09064Medicare UPIN
IL36104085Medicaid