Provider Demographics
NPI:1376733295
Name:GAUSCHE, ERIC (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:
Last Name:GAUSCHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 N. LAKE SHORE DRIVE
Mailing Address - Street 2:SUITE #1000
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-8709
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:680 N. LAKE SHORE DRIVE
Practice Address - Street 2:SUITE #1000
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-8709
Practice Address - Country:US
Practice Address - Phone:312-695-0665
Practice Address - Fax:312-695-0050
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361240892084B0040X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry