Provider Demographics
NPI:1346423464
Name:BENEDICT L GIERL MD AND ASSOCIATES LTD
Entity Type:Organization
Organization Name:BENEDICT L GIERL MD AND ASSOCIATES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:LEO
Authorized Official - Last Name:GIERL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-386-1831
Mailing Address - Street 1:320 N LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2506
Mailing Address - Country:US
Mailing Address - Phone:708-386-1831
Mailing Address - Fax:170-838-6429
Practice Address - Street 1:320 N LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2506
Practice Address - Country:US
Practice Address - Phone:708-386-1831
Practice Address - Fax:170-838-6429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360662712084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL950540Medicare PIN
ILC45862Medicare UPIN