Gerald M. Bedore, APN/CNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

209.004416 Issued in IL

Practice address

835 S Wolcott Ave RM E-144
Chicago, IL 60612-3748

Phone

(312) 996-7420

Fax

(312) 413-8485

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Board of Trustees of the University of Illinois

  • Pediatrics Physician
  • Peoria, IL
  • NPI 1467425322
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212710400000",
    "number": "1003075706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 S WOLCOTT AVE RM E-144",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123748",
            "telephone_number": "312-996-7420",
            "fax_number": "312-413-8485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 S WOLCOTT AVE RM E-144",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123748",
            "telephone_number": "312-996-7420",
            "fax_number": "312-413-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDORE",
        "first_name": "GERALD",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "APN/CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209.004416",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.004416",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Landon Bednarski, MD
• Justine Maria Bednarski, DDS
• Mary S Bednarz, R.PH
• Nina Bednarz
• Ana Bedon
• Jennifer Pamela Bedoy, LPC
• Nestor Javier Bedoya, MD
• Ana Karina Bedran-Russo, DDS
• Emese Bedrosian
• Helen Bedross, RN

• Adult Health Nurse Practitioner in Chicago, IL
• Providers in Chicago, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.