Individual provider Active NPI

Francesca Jessica Gattuso, D.D.S.

  • Dentist
  • Chicago, IL
National Provider Identifier
1003266958
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030707 Issued in IL
Practice address
4516 S Damen Ave
Chicago, IL 60609-3013
Phone
(773) 869-0200
NPI assigned
Jun 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030707 IL Primary

Addresses

Primary practice location

4516 S Damen Ave
Chicago, IL 60609-3013

Mailing address

2316 W Madison St
Chicago, IL 60612-2228
Phone (312) 491-0601

Other practice location 1

2316 W Madison St
Chicago, IL 60612-2228
Phone (312) 491-0601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160823002323 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6608161112

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019030707ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ash Dental PC Dentist Past Accepting new patients
Studio Dental, LLC Past Accepting new patients

Networks

  • IL HMO C-SNP
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1003266958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606122228",
            "telephone_number": "312-491-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4516 S DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606093013",
            "telephone_number": "773-869-0200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2316 W Madison St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606122228",
            "country_code": "US",
            "telephone_number": "312-491-0601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATTUSO",
        "first_name": "FRANCESCA",
        "middle_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.