Provider Demographics
NPI:1992031751
Name:GILLANI, STEVE M
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:M
Last Name:GILLANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 E WACKER DR
Mailing Address - Street 2:LL02
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-3713
Mailing Address - Country:US
Mailing Address - Phone:312-861-1953
Mailing Address - Fax:312-861-1955
Practice Address - Street 1:111 E WACKER DR
Practice Address - Street 2:LL02
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-3713
Practice Address - Country:US
Practice Address - Phone:312-861-1953
Practice Address - Fax:312-861-1955
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171R00000X, 174400000X
ILG45079364078172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171R00000XOther Service ProvidersInterpreter
No172A00000XOther Service ProvidersDriver