Provider Demographics
NPI:1992002711
Name:FERRERA, GABRIELA ISABEL (MD)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:ISABEL
Last Name:FERRERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3722 HARLEM AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-2331
Mailing Address - Country:US
Mailing Address - Phone:708-783-6500
Mailing Address - Fax:708-442-6599
Practice Address - Street 1:3722 HARLEM AVE STE 101
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-2331
Practice Address - Country:US
Practice Address - Phone:708-783-6500
Practice Address - Fax:708-442-6599
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036129444207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine