Basic Information
| Provider Information | |||||||||
| NPI: | 1851882344 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BARAN | ||||||||
| FirstName: | GABRIELLA | ||||||||
| MiddleName: | MARIA | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 333 PINE RIDGE BLVD | ||||||||
| Address2: | |||||||||
| City: | WAUSAU | ||||||||
| State: | WI | ||||||||
| PostalCode: | 544014102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7158472121 | ||||||||
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| Practice Location | |||||||||
| Address1: | 135 N OAK ST | ||||||||
| Address2: | |||||||||
| City: | HINSDALE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605213860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6308568900 | ||||||||
| FaxNumber: | 6308568933 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2018 | ||||||||
| LastUpdateDate: | 10/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 75106-21 | WI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.