Provider Demographics
NPI:1710356746
Name:GATLIN, MARGARET M
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:M
Last Name:GATLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-1026
Mailing Address - Country:US
Mailing Address - Phone:224-800-6978
Mailing Address - Fax:847-854-8248
Practice Address - Street 1:18 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1026
Practice Address - Country:US
Practice Address - Phone:224-800-6978
Practice Address - Fax:847-854-8248
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILG34557359962344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi