NPIMap

Individual provider Active NPI

Carmen Gnatenco, M.D.

  • Internal Medicine Physician
  • Palos Heights, IL
National Provider Identifier
1043363708
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036-115290 Issued in IL
Practice address
12211 S Harlem Ave
Palos Heights, IL 60463-1471
Phone
(708) 295-9399
Fax
(866) 920-1134
NPI assigned
Jan 18, 2007
Last updated
Sep 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036-115290 IL Primary

Addresses

Primary practice location

12211 S Harlem Ave
Palos Heights, IL 60463-1471

Mailing address

12211 S Harlem Ave
Palos Heights, IL 60463-1471
Phone (708) 295-9399

Other names 1

  • Carmen Dumitrachi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070404000519 IL Practitioner - Internal MedicinePractitioner - General Practice 4183728892 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: General Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12211 S Harlem Ave
FL 2
Palos Heights, IL 60463-1471
Phone (708) 295-9399

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
23.67 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
78.89

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-115290ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carmen Gnatenco M.D., S.C. Internal Medicine CurrentSince Jul 8, 2008 Accepting new patients

Locations

4938 W 95th St
Oak Lawn, IL 60453
Phone (708) 425-4662

12211 S Harlem Ave
Fl 2
Palos Heights, IL 60463
Phone (708) 295-9399

6400 W College Dr
Ste 600
Palos Heights, IL 60463
Phone (708) 389-3224

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1043363708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12211 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631471",
            "telephone_number": "708-295-9399",
            "fax_number": "866-920-1134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12211 S HARLEM AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631471",
            "telephone_number": "708-295-9399",
            "fax_number": "866-920-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GNATENCO",
        "first_name": "CARMEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036-115290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "DUMITRACHI",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palos Heights, IL

Sources for this page

Verify at the official NPI Registry.