Individual provider Active NPI

Gaurang Gujarathi, DO

  • Cardiovascular Disease Physician
  • Palos Park, IL
National Provider Identifier
1124314349
Registry record updated Aug 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036133707 Issued in IL
Practice address
13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone
(708) 478-4224
Fax
(708) 274-3299
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 036133707 IL Primary

Addresses

Primary practice location

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508

Mailing address

13011 S 104TH Ave Ste 100
Palos Park, IL 60464-1508
Phone (708) 478-3600

Other practice location 1

10260 191st St Ste 102
Mokena, IL 60448-8802
Phone (708) 478-4224

Other identifiers 1

IdentifierTypeStateIssuer
036133707OtherILSTATE LICENSE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130805000280 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Osteopathic Manipulative Medicine 6507008547 Reassigns benefits to 1 organization
Practice locations: Kankakee, IL

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine, Osteopathic Manipulative Medicine
Education
West Virginia School of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Illinois Medical Group LLCGroup PAC ID 5597275685, 278 clinicians

Practice addresses (Care Compare)

100 N River Rd
Des Plaines, IL 60016-1209
Phone (847) 297-1800

100 Provena Way
Suite 103
Bourbonnais, IL 60914-4797
Phone (815) 937-8780

100 Provena Way
Suite C
Bourbonnais, IL 60914-4798
Phone (815) 937-9370

455 W Court St
Kankakee, IL 60901-3695

500 W Court St
Kankakee, IL 60901-3661
Phone (815) 937-2400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Illinois Medical Group LLC CurrentSince Jun 15, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

1801 W Olympic Blvd
#2636
Pasadena, CA 91199

1325 N Highland Ave
Aurora, IL 60506
Phone (630) 801-2756

100 Provena Way
Ste 103
Bourbonnais, IL 60914
Phone (815) 937-8780

100 Provena Way
Ste C
Bourbonnais, IL 60914
Phone (815) 936-3200

100 N River Rd
Des Plaines, IL 60016
Phone (847) 297-1800

201 N Hammes Ave
Joliet, IL 60435
Phone (224) 273-6350

1710 W Court St
Kankakee, IL 60901
Phone (815) 936-3200

200 E Fairman Ave
Watseka, IL 60970
Phone (815) 432-5201

Interoperability endpoints

  • Direct secure messaging: gaurang.gujarathi.1@15486.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787875200000",
    "number": "1124314349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE STE 100",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-478-3600",
            "fax_number": "708-390-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13011 S 104TH AVE STE 100",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604641508",
            "telephone_number": "708-478-4224",
            "fax_number": "708-274-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10260 191st St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Mokena",
            "state": "IL",
            "postal_code": "604488802",
            "country_code": "US",
            "telephone_number": "708-478-4224",
            "fax_number": "708-478-4033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUJARATHI",
        "first_name": "GAURANG",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036133707",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036133707",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palos Park, IL

Sources for this page

Verify at the official NPI Registry.