Mark Robert Gannon, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070024237 Issued in IL

Practice address

2011 York Rd Ste 1500
Oak Brook, IL 60523

Phone

(877) 632-6637

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthomidwest, PLLCGroup PAC ID 0749183713, 531 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mark.gannon.1@12576.direct.athenahealth.com

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.

• Orthomidwest, PLLC

  • Orthopaedic Surgery Physician
  • Rockford, IL
  • NPI 1730136474

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Midwest Orthopaedics at Rush, LLC

  • Orthopaedic Surgery Physician
  • Chicago, IL
  • NPI 1811942451
  Medicare reassignment NPD
• Midwest Orthopaedics at Rush LLC

  • Durable Medical Equipment & Medical Supplies
  • Orland Park, IL
  • NPI 1134871908
  NPD
• Orthomidwest, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Buffalo Grove, IL
  • NPI 1043180839
  NPD
• Orthomidwest, PLLC

  • Durable Medical Equipment & Medical Supplies
  • McHenry, IL
  • NPI 1346866373
  NPD
• Endurance Rehabilitation LLC

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1497061774
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1093737397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 OAKMONT LN STE 600C",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605595548",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2011 YORK RD STE 1500",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "60523",
            "telephone_number": "877-632-6637"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6309 E Baywood Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061744",
            "country_code": "US",
            "telephone_number": "480-325-3801 x146",
            "fax_number": "480-325-3801",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6309 E Baywood Ave",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852061744",
            "country_code": "US",
            "telephone_number": "480-325-3801 x146",
            "fax_number": "480-325-3801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "MARK",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070024237",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "6877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viviana Gallegos Alvarado
• Kenya Galloway, RBT
• Gandhi Mohandas Gutta, M.D.S.C
• Manish R Gandhi, DDS
• Nayan V Gandhi, M.D.
• Mary L. Gannon, M.D.,C.A.D.C.
• Jessica L Garcia, MD
• Kelly Suzanne Garcia, BSN, RN, FNP-BC
• Isaiah V Gardiner
• Beth Gasaway, LCPC

• Physical Therapist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.