Active NPI
Puja Sheth Gogawale, M.D.
- Obstetrics & Gynecology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036143697
- Practice address
- 1701 W Superior St FL 2
Chicago, IL 60622-5646 - Phone
- (312) 666-3494
- NPI assigned
- May 10, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036143697 | IL | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 125.063473 | IL |
Addresses
Primary practice location
1701 W Superior St FL 2
Chicago, IL 60622-5646
Mailing address
250 E Superior St
Chicago, IL 60611-2914
Phone (312) 926-2000
Other practice location 1
250 E Superior St
Chicago, IL 60611-2914
Phone (312) 926-2000
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Wayne State University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1504 S Albany Ave
Chicago, IL 60623-2209
Phone (312) 666-3494
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.063473 | IL | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Erie Family Health Center Inc | Current | Accepting new patients | |
| Little Company of Mary Affiliated Services Inc | Obstetrics & Gynecology | Current | Accepting new patients |
| Little Company of Mary Affiliated Services Inc | Current | Accepting new patients | |
| Erie Family Health Center, Inc | Current | Accepting new patients | |
| Erie Family Health Center Inc | Current | Accepting new patients |
Locations
1701 W Superior St
Chicago, IL 60622
Phone (312) 432-7392
1701 W Superior St
Fl 2
Chicago, IL 60622
Phone (323) 361-2122
1701 W Superior St
Fl 3
Chicago, IL 60622
Phone (312) 432-7381
1504 S Albany Ave
Chicago, IL 60623
2800 W 87th St
Chicago, IL 60652
Phone (312) 423-4200
2850 W 95th St
Ste 203
Evergreen Pk, IL 60805
Phone (708) 422-1222
660 N Westmoreland Rd
#302
Lake Forest, IL 60045
12450 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 448-1207
Interoperability endpoints
- pgogawale368514@direct.ochin.org
Organizations & group practices 5
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.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1760499545
-
dba Little Co of Mary Care Station
- Urgent Care Clinic/Center
- Oak Lawn, IL
- NPI 1033162086
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1548062318
-
dba Erie Division Street Health Center
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1700144243
-
dba Little Co of Mary Affiliated
- Internal Medicine Physician
- Evergreen Park, IL
- NPI 1588617260
Obstetrics & Gynecology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695686400000",
"number": "1093151573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 E SUPERIOR ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606112914",
"telephone_number": "312-926-2000",
"fax_number": "312-472-0141"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 W SUPERIOR ST FL 2",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606225646",
"telephone_number": "312-666-3494"
}
],
"practiceLocations": [
{
"address_1": "250 E Superior St",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606112914",
"country_code": "US",
"telephone_number": "312-926-2000",
"fax_number": "312-472-0141",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOGAWALE",
"first_name": "PUJA",
"middle_name": "SHETH",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-10",
"last_updated": "2023-09-26",
"certification_date": "2023-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036143697",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "125.063473",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.