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Contact Information

GAIL E PRENDERGAST, MD
403 E. 1ST STREET
KATHERINE SHAW BETHEA HOSPITAL
DIXON, IL61021
 Phone: 815-285-5629
 Fax: 815-285-5634
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hospitalist

208M00000X
Indicates primary specialty

NPI Profile & details for GAIL E PRENDERGAST · (Female)

NPI # 1548294184
Status Active
Credentials MD
Entity Individual
Enumeration date 07/10/2006
Last updated 09/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-102246
  • IL License # 036102246
  • IL Medicaid 036102246
  • IL Other 0222075 BLUE CROSS GROUP NUMER
  • IL Other F400261482 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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