Provider Demographics
NPI:1487190732
Name:DOCTORS ON SITE, LTD
Entity Type:Organization
Organization Name:DOCTORS ON SITE, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:GAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-882-2030
Mailing Address - Street 1:1 EXECUTIVE CT
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SOUTH BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-9533
Mailing Address - Country:US
Mailing Address - Phone:847-882-2030
Mailing Address - Fax:
Practice Address - Street 1:1 EXECUTIVE CT
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-9533
Practice Address - Country:US
Practice Address - Phone:847-882-2030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-10
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209014071363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1083076871Medicare NSC