Active NPI
Gaurang Gujarathi, DO
- Cardiovascular Disease Physician
- Palos Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 036133707
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036133707 | Other | IL | STATE 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- West Virginia School of Osteopathic Medicine, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
- Presence St Marys Hospital
- Iroquois Memorial Hospital
- Riverside Medical Center
- Carle Foundation Hospital
- Carle Bromenn Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Pacemaker insertion or repair | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prime Healthcare Illinois Medical Group LLC | Current | 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
- 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.
-
- Multi-Specialty Clinic/Center
- Des Plaines, IL
- NPI 1023837689
-
- Critical Access Hospital
- Gibson City, IL
- NPI 1114935681
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Normal, IL
- NPI 1962424036
-
- Critical Access Hospital
- Watseka, IL
- NPI 1629003470
-
- General Acute Care Hospital
- Kankakee, IL
- NPI 1538208210
-
- General Acute Care Hospital
- Kankakee, IL
- NPI 1467290809
-
- General Acute Care Hospital
- Urbana, IL
- NPI 1013071653
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.