Individual provider Active NPI

Agata Gebala

  • Physician Assistant
  • Kankakee, IL
National Provider Identifier
1033069869
Registry record updated Jan 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
375 N Wall St
Kankakee, IL 60901-3483
Phone
(815) 933-1671
NPI assigned
Jan 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

375 N Wall St
Kankakee, IL 60901-3483

Mailing address

2 W Pebble CT Apt a
Palos Hills, IL 60465-3298

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260309000235 IL Practitioner - Physician Assistant 8527541515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Emergency Physicians LLCGroup PAC ID 6204294119, 35 clinicians

Practice addresses (Care Compare)

350 N Wall St
Kankakee, IL 60901-2901
Phone (815) 933-1671

Hospital & facility affiliations

  • Riverside Medical Center Hospital, Kankakee, IL, CCN 140186

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Emergency Physicians, LLC CurrentSince Feb 4, 2026 Accepting new patients

Locations

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1769817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769817600000",
    "number": "1033069869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W PEBBLE CT APT A",
            "city": "PALOS HILLS",
            "state": "IL",
            "postal_code": "604653298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 N WALL ST",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609013483",
            "telephone_number": "815-933-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEBALA",
        "first_name": "AGATA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-31",
        "last_updated": "2026-01-31",
        "certification_date": "2026-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kankakee, IL

Sources for this page

Verify at the official NPI Registry.