Provider Demographics
NPI:1679991160
Name:HEIBER BENDAYAN, GABRIEL JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:GABRIEL
Middle Name:JOSE
Last Name:HEIBER BENDAYAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:GABRIEL
Other - Middle Name:
Other - Last Name:HEIBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1100 CENTRAL AVE STE F-3
Mailing Address - Street 2:
Mailing Address - City:WILMETTE
Mailing Address - State:IL
Mailing Address - Zip Code:60091-2666
Mailing Address - Country:US
Mailing Address - Phone:312-600-8533
Mailing Address - Fax:
Practice Address - Street 1:1100 CENTRAL AVE STE F-3
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2666
Practice Address - Country:US
Practice Address - Phone:312-600-8533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1414602084P0015X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry