Provider Demographics
NPI:1538675715
Name:GITELIS ORTHOPEDICS LTD
Entity Type:Organization
Organization Name:GITELIS ORTHOPEDICS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GITELIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-807-7770
Mailing Address - Street 1:1800 MCDONOUGH RD STE 202
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-4565
Mailing Address - Country:US
Mailing Address - Phone:847-807-7770
Mailing Address - Fax:847-807-7771
Practice Address - Street 1:1800 MCDONOUGH RD STE 202
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60192-4565
Practice Address - Country:US
Practice Address - Phone:847-807-7770
Practice Address - Fax:847-807-7771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-25
Last Update Date:2017-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036055465207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4028613OtherAETNA INSURANCE
IL193531OtherUNITED HEALTHCARE
IL180709OtherCOVENTRY HEALTHCARE
IL5369851OtherCIGNA INSURANCE
IL176690556237OtherHUMANA INSURANCE