Mary Ellen Gruszka, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036061958 Issued in IL

Practice address

8711 W Cermak Rd
North Riverside, IL 60546-1166

Phone

(708) 442-7979

Fax

(708) 442-8574

NPI assigned

Aug 24, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24409/brand/1/csg/1/fhir/r4

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.

• FGM Pediatrics SC

  • Pediatrics Physician
  • North Riverside, IL
  • NPI 1780633313
  NPD (past)

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

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435536000000",
    "number": "1073506101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8711 W CERMAK RD",
            "city": "NORTH RIVERSIDE",
            "state": "IL",
            "postal_code": "605461166",
            "telephone_number": "708-442-7979",
            "fax_number": "708-442-8574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSZKA",
        "first_name": "MARY ELLEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-24",
        "last_updated": "2015-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036061958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061958",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Garcia
• Elizabeth Garcia
• Luis Garcia
• Lora Gardiner
• Merry C Gindorf, O.D.
• Guadalupe Guzman, PHARM,D.
• Emily Halvorson
• Debbie Denean Haymon, OT
• Phoenix Ariel Henry
• Hergesheimer Chiropractic PC (5TH Avenue Chiropractic Center)

• Pediatrics Physician in North Riverside, IL
• Providers in North Riverside, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.