Provider Demographics
NPI:1639585243
Name:GILBERT, ERICA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:GILBERT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:WEINBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:1707 SHERMER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-5316
Mailing Address - Country:US
Mailing Address - Phone:847-498-1595
Mailing Address - Fax:
Practice Address - Street 1:1707 SHERMER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-5316
Practice Address - Country:US
Practice Address - Phone:847-498-1595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL12239122300000X
IL021.0027771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist