Basic Information
| Provider Information | |||||||||
| NPI: | 1497259287 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOBATO | ||||||||
| FirstName: | GABRIELA | ||||||||
| MiddleName: | C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 749 UNIVERSITY ROW | ||||||||
| Address2: | STE 200 | ||||||||
| City: | MADISON | ||||||||
| State: | WI | ||||||||
| PostalCode: | 537051465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082164943 | ||||||||
| FaxNumber: | 7082164943 | ||||||||
| Practice Location | |||||||||
| Address1: | 2160 S 1ST AVE | ||||||||
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| City: | MAYWOOD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7082164943 | ||||||||
| FaxNumber: | 7082164943 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2018 | ||||||||
| LastUpdateDate: | 07/07/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125.071868 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.