Individual provider Active NPI

John Drew Gorrell, DDS

  • General Practice Dentistry
  • Elk Grove Village, IL
National Provider Identifier
1194731877
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Practice address
958 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754
Phone
(847) 364-5100
Fax
(847) 364-9807
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Primary

Addresses

Primary practice location

958 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754

Mailing address

958 Elk Grove Town Ctr
Elk Grove Village, IL 60007-3754
Phone (847) 364-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019019565ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194731877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 ELK GROVE TOWN CTR",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073754",
            "telephone_number": "847-364-5100",
            "fax_number": "847-364-9807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 ELK GROVE TOWN CTR",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073754",
            "telephone_number": "847-364-5100",
            "fax_number": "847-364-9807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORRELL",
        "first_name": "JOHN",
        "middle_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove Village, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.