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Jack Michael Gibson, MD
Obstetrics & Gynecology Physician in Peoria, Illinois
NPI 1346235777

Jack Michael Gibson is a Obstetrics & Gynecology Physician based in Peoria, IL. Jack Michael Gibson practices in Peoria, IL and has the professional credentials of MD. The NPI Number for Jack Michael Gibson is 1346235777 and holds a License No. 036064619 (Illinois).

The current practice location address for Jack Michael Gibson is 530 Ne Glen Oak Ave, Peoria, IL and can be reached out via phone at 309-696-2297.

Location: 530 Ne Glen Oak Ave, Peoria, IL, 61637-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1346235777
Provider Name
Jack Michael Gibson
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
530 Ne Glen Oak Ave, Peoria, IL, 61637-0001
Phone Number
309-696-2297
Fax Number
Provider Enumeration Date
09/12/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
007200621 01 IL BLUE CROSS BLUE SHIELD
036064619 05 IL
institution
Provider Business Practice Location Address Details
Address
530 Ne Glen Oak Ave
City
Peoria
State
Illinois
Zip
61637-0001
Phone Number
309-696-2297
Fax Number
person
Provider Business Mailing Address Details
Address
530 Ne Glen Oak Ave
City
Peoria
State
Illinois
Zip
61637-0001
Phone Number
309-696-2297
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Obstetrics & Gynecology
Speciality
-
Taxonomy
207V00000X
License No.
036064619 (Illinois)
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
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