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Mehdat Gabriel

Radiology

Allopathic & Osteopathic Physicians

Loyola University Medical Center, Mcgaw Ent., Rm. 47, Maywood, IL 60153

PECOS Enrollment

This provider is enrolled in PECOS as MEDHAT GABRIEL.

Based on the most recent information from CMS, provider Mehdat Gabriel is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1497824908
Provider Type
Individual
Full Name
Gabriel, Mehdat
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
11/7/2006
Last Updated
5/7/2021

Contact Information

Practice Location

Loyola University Medical Center, Mcgaw Ent., Rm. 47, Maywood, IL 60153

(708) 216-5221

(708) 216-0899

Mailing Location

Loyola University Medical Center, Mcgaw Ent., Rm. 47, Maywood, IL 60153

(708) 216-5221

(708) 216-0899

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 036-105453 Illinois
Code 207U00000X	Description Nuclear Medicine Allopathic & Osteopathic Physicians	License 036-105453 Illinois

Provider Identifiers

ID	Description	Issuer
ID K24227	Description Other	Issuer MEDICARE Illinois

Mehdat Gabriel

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Shah, Love

Rajpoot, Ravi

Patel, Himanshu Bharat

Mian, Farukh Saeed

Mosenthal, Mckenzie

Kral, Madonna

Sheikh, Muhammad M

Mullen, Sheila

Niemeyer, Kathryn Elizabeth

Olson, Mary