Basic Information
| Provider Information | |||||||||
| NPI: | 1497986525 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GILL | ||||||||
| FirstName: | AMAN | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14120 RUSSELL ST | ||||||||
| Address2: | APT 2607 | ||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662232593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3014015300 | ||||||||
| FaxNumber: | 3175766311 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 N MUR LEN RD | ||||||||
| Address2: | # 8 | ||||||||
| City: | OLATHE | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660625431 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137645100 | ||||||||
| FaxNumber: | 9137645101 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/06/2009 | ||||||||
| LastUpdateDate: | 03/01/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 04-39381 | KS | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 201142310A | 05 | KS | MEDICAID |