Provider Demographics
NPI:1922124569
Name:NERI, GENE O (MD)
Entity Type:Individual
Prefix:MR
First Name:GENE
Middle Name:O
Last Name:NERI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:333 CHESTNUT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3247
Mailing Address - Country:US
Mailing Address - Phone:630-654-3636
Mailing Address - Fax:630-654-3680
Practice Address - Street 1:333 CHESTNUT ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3247
Practice Address - Country:US
Practice Address - Phone:630-654-3636
Practice Address - Fax:630-654-3680
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2015-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL0360458822084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036045882Medicaid
IL036045882Medicaid
C45976Medicare UPIN