Provider Demographics
NPI:1790702538
Name:GASTROINTESTINAL HEALTH SPECIALISTS,L.L.C.
Entity Type:Organization
Organization Name:GASTROINTESTINAL HEALTH SPECIALISTS,L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TARUN
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLICK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-232-2025
Mailing Address - Street 1:2631 WILLIAMSBURG AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-1101
Mailing Address - Country:US
Mailing Address - Phone:630-232-2025
Mailing Address - Fax:630-232-2780
Practice Address - Street 1:2631 WILLIAMSBURG AVE
Practice Address - Street 2:SUITE 301
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-1101
Practice Address - Country:US
Practice Address - Phone:630-232-2025
Practice Address - Fax:630-232-2780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-17
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036108726174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDC9061OtherRAILROAD MEDICARE
IL04532244OtherBLUE CROSS BLUE SHIELD
ILDC9061OtherRAILROAD MEDICARE
ILH61165Medicare UPIN
IL=========6013201Medicaid
IL04532244OtherBLUE CROSS BLUE SHIELD