Provider Demographics
NPI:1801392378
Name:GILL-WIEHL, GENEVIEVE FLORENCE (MD)
Entity Type:Individual
Prefix:
First Name:GENEVIEVE
Middle Name:FLORENCE
Last Name:GILL-WIEHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:FLORENCE
Other - Last Name:WIEHL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1750 W HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3825
Mailing Address - Country:US
Mailing Address - Phone:312-942-6510
Mailing Address - Fax:
Practice Address - Street 1:1750 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-942-6510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-03
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program