Provider Demographics
NPI:1407260227
Name:GIDAY, GENET (MD)
Entity Type:Individual
Prefix:
First Name:GENET
Middle Name:
Last Name:GIDAY
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 1:855 ILLINI DR STE 303
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2904
Mailing Address - Country:US
Mailing Address - Phone:309-281-2350
Mailing Address - Fax:
Practice Address - Street 1:855 ILLINI DR STE 303
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-2904
Practice Address - Country:US
Practice Address - Phone:309-281-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY275632208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics