Provider Demographics
NPI:1598414708
Name:GOHL, TREVOR GLENN (DO)
Entity Type:Individual
Prefix:
First Name:TREVOR
Middle Name:GLENN
Last Name:GOHL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4203
Mailing Address - Country:US
Mailing Address - Phone:630-208-3000
Mailing Address - Fax:
Practice Address - Street 1:298 RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4203
Practice Address - Country:US
Practice Address - Phone:630-208-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-23
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program