Individual provider Active NPI

Gail L Pollock, CCC-A

  • Audiologist
  • Morton, IL
National Provider Identifier
1063602514
Registry record updated Jul 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
636 W Jefferson St
Suite 3C
Morton, IL 61550-1581
Phone
(309) 263-7545
NPI assigned
Jul 31, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X IL Primary

Addresses

Primary practice location

636 W Jefferson St
Suite 3C
Morton, IL 61550-1581

Mailing address

636 W Jefferson St
Suite 3C
Morton, IL 61550-1581
Phone (309) 263-7545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
147-000027ILMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185840000000",
    "number": "1063602514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 W JEFFERSON ST",
            "address_2": "SUITE 3C",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501581",
            "telephone_number": "309-263-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 W JEFFERSON ST",
            "address_2": "SUITE 3C",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615501581",
            "telephone_number": "309-263-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLLOCK",
        "first_name": "GAIL",
        "middle_name": "L",
        "credential": "CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-31",
        "last_updated": "2007-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2007; 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.