Fullerton Drake Medical Center

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

FULLERTON DRAKE MEDICAL CENTER

Practice address

3518 W Fullerton Ave
Chicago, IL 60647-2418

Phone

(773) 278-0334

NPI assigned

Dec 4, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Mark K Gerber, MDNPI 1124037890

Title

President

Phone

(773) 278-0334

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark K Gerber, M.D.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1124037890
  NPD Authorized official

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701648000000",
    "number": "1104693845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472418",
            "telephone_number": "773-278-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472418",
            "telephone_number": "773-278-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLERTON DRAKE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A",
        "authorized_official_last_name": "GERBER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-278-0334",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Fuller
• Mary-Bianca Gabrielle Fuller
• Michael Alan Fuller, MD
• Rachel Marie Fuller, PT, DPT
• Fullerton Dental Island LLC
• Fullerton Family Dentistry, LTD
• Fullerton Kedzie Professional Pharmacy
• Fullerton Kimball Medical & Surgical Center
• Fullerton Kimball Medical Group SC
• Fullerton Medical Surgical Center

• Non-Pharmacy Dispensing Site in Chicago, IL
• Providers in Chicago, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.