SearchIllinois101YM0800X

Gerald Odom

NPI 1548535966 · on the registry since 2012

Practice

Address
3010 Grand Ave
Waukegan, IL 60085
Phone
(284) 737-7868
Fax
(847) 377-8688
Organisation at this address
Cabs
County Of Lake
County Of Lake
County Of Lake
County Of Lake
Inferred from a shared address, not stated in the registry.
Clinicians at this address
349

Registry record

Primary taxonomy
101YM0800X
101YM0800X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2012-03-19

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois