Provider Demographics
NPI:1275080871
Name:GILL, CARINA (PA)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:
Other - Last Name:HILBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:611 W. PARK ST.
Mailing Address - Street 2:BWPC
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2500
Mailing Address - Country:US
Mailing Address - Phone:217-383-6941
Mailing Address - Fax:
Practice Address - Street 1:611 W. PARK ST.
Practice Address - Street 2:GASTROENTEROLOGY
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2500
Practice Address - Country:US
Practice Address - Phone:217-383-3610
Practice Address - Fax:217-326-2704
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085006034363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant