Provider Demographics
NPI:1487609343
Name:GERBER, BRIAN S (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:S
Last Name:GERBER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:750 FLETCHER DR
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4703
Mailing Address - Country:US
Mailing Address - Phone:847-697-7011
Mailing Address - Fax:847-697-8545
Practice Address - Street 1:750 FLETCHER DR
Practice Address - Street 2:SUITE 203
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4703
Practice Address - Country:US
Practice Address - Phone:847-697-7011
Practice Address - Fax:847-697-8545
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-90943208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG68448Medicare UPIN
ILK18179Medicare PIN