Individual provider Active NPI

Gail Kreke, LPN

  • Licensed Practical Nurse
  • Effingham, IL
National Provider Identifier
1083852685
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
043036499 Issued in IL
Practice address
901 Medical Park Dr
Suite 100
Effingham, IL 62401-2191
Phone
(217) 347-3003
Fax
(217) 347-3005
NPI assigned
Feb 4, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043036499 IL Primary

Addresses

Primary practice location

901 Medical Park Dr
Suite 100
Effingham, IL 62401-2191

Mailing address

901 Medical Park Dr
Suite 100
Effingham, IL 62401-2191
Phone (217) 347-3003

Other identifiers 2

IdentifierTypeStateIssuer
746960OtherHEALTHLINK
2500075OtherILBCBS

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
043036499ILMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1083852685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 MEDICAL PARK DR",
            "address_2": "SUITE 100",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012191",
            "telephone_number": "217-347-3003",
            "fax_number": "217-347-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 MEDICAL PARK DR",
            "address_2": "SUITE 100",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012191",
            "telephone_number": "217-347-3003",
            "fax_number": "217-347-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREKE",
        "first_name": "GAIL",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043036499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "746960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2500075",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.