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Jason Thomas Gambla
Electroneurodiagnostic Specialist/Technologist in Oak Lawn, Illinois
NPI 1093437337

Jason Thomas Gambla is a Electroneurodiagnostic Specialist/Technologist based in Las Vegas, IL and is specialized in Electroneurodiagnostic. Jason Thomas Gambla practices in Oak Lawn, IL. The NPI Number for Jason Thomas Gambla is 1093437337 and holds a License No. (Illinois).

The current practice location address for Jason Thomas Gambla is 4440 W 95Th St, Oak Lawn, IL and can be reached out via phone at 708-684-8000.

Location: 4440 W 95Th St, Oak Lawn, IL, 89128-4340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093437337
Provider Name
Jason Thomas Gambla
Credential
Provider Entity Type
Individual
Gender
Male
Address
4440 W 95Th St, Oak Lawn, IL, 89128-4340
Phone Number
708-684-8000
Fax Number
Provider Enumeration Date
09/14/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
012357877 01 OTHER
institution
Provider Business Practice Location Address Details
Address
4440 W 95Th St
City
Oak Lawn
State
Illinois
Zip
60453-2600
Phone Number
708-684-8000
Fax Number
person
Provider Business Mailing Address Details
Address
4440 W 95Th St
City
Oak Lawn
State
Illinois
Zip
60453-2600
Phone Number
708-684-8000
Fax Number
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Specialist/Technologist, Other
Speciality
Electroneurodiagnostic
Taxonomy
246ZE0600X
License No.
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Definition
Definition to come...
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