Individual provider Active NPI

Gabrielle Loeck

  • Physician Assistant
  • New Lenox, IL
National Provider Identifier
1184451213
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1870 Silver Cross Blvd Ste 200
New Lenox, IL 60451-8646
Phone
(630) 323-6116
Fax
(815) 462-1032
NPI assigned
Sep 13, 2024
Last updated
Sep 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1870 Silver Cross Blvd Ste 200
New Lenox, IL 60451-8646

Mailing address

900 Rand Rd Ste 300
Des Plaines, IL 60016-2359
Phone (847) 324-3976

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022002098 IL Practitioner - Physician Assistant 8729510268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

2101 Waukegan Rd
Bannockburn, IL 60015-1836

4700 Gilbert Ave
Suite 51
Western Springs, IL 60558-1664
Phone (708) 387-1750

550 W Ogden Ave
Hinsdale, IL 60521-3186
Phone (630) 323-6116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Bone and Joint Institute LLC CurrentSince Oct 14, 2024 Accepting new patients
Illinois Bone and Joint Institute, LLC CurrentSince Oct 14, 2024 Accepting new patients

Locations

2101 Waukegan Rd
Ste 110
Bannockburn, IL 60015
Phone (847) 914-9096

5057 Paysphere Cir
Chicago, IL 60674

900 Rand Rd
Ste 300
Des Plaines, IL 60016
Phone (847) 324-3090

1034 Warren Ave
Downers Grove, IL 60515
Phone (630) 852-7325

550 W Ogden Ave
Hinsdale, IL 60521
Phone (630) 323-6116

1870 Silver Cross Blvd
Ste 200
New Lenox, IL 60451
Phone (630) 323-6116

4700 Gilbert Ave
Ste 51
Western Springs, IL 60558
Phone (708) 387-1737

1010 Executive Dr
Ste 250
Westmont, IL 60559
Phone (630) 655-8785

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1184451213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 RAND RD STE 300",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600162359",
            "telephone_number": "847-324-3976",
            "fax_number": "847-929-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 SILVER CROSS BLVD STE 200",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604518646",
            "telephone_number": "630-323-6116",
            "fax_number": "815-462-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOECK",
        "first_name": "GABRIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.