Provider Demographics
NPI:1053609248
Name:GELBMANN, DAVID BENJAMIN (DPM)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BENJAMIN
Last Name:GELBMANN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 S MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2822
Mailing Address - Country:US
Mailing Address - Phone:312-880-0067
Mailing Address - Fax:312-880-0071
Practice Address - Street 1:1440 S MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-2822
Practice Address - Country:US
Practice Address - Phone:312-880-0067
Practice Address - Fax:312-880-0071
Is Sole Proprietor?:No
Enumeration Date:2011-07-21
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.005601213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400141158OtherMEDICARE PTAN
ILF400141158Medicare PIN