Active NPI
Irving Gonzalez
- Athletic Trainer
- Whiting, IN
National Provider Identifier
1205244688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 36002219A
- Practice address
- 1921 Davis Ave
Whiting, IN 46394-1820 - Phone
- (219) 659-3522
- Fax
- (219) 554-4571
- NPI assigned
- Jul 29, 2014
- Last updated
- Jul 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36002219A | IN | Primary |
| Athletic Trainer | 2255A2300X | 096003543 | IL |
Addresses
Primary practice location
1921 Davis Ave
Whiting, IN 46394-1820
Mailing address
2604 S Emerald Ave
Apartment C
Chicago, IL 60616-2525
Phone (847) 791-0240
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
| License | State | Type | Specialty |
|---|---|---|---|
| 096003543 | IL | MD | Athletic Trainer |
| 36002219A | IN | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1205244688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2604 S EMERALD AVE",
"address_2": "APARTMENT C",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606162525",
"telephone_number": "847-791-0240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1921 DAVIS AVE",
"city": "WHITING",
"state": "IN",
"postal_code": "463941820",
"telephone_number": "219-659-3522",
"fax_number": "219-554-4571"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GONZALEZ",
"first_name": "IRVING",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-29",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IN",
"license": "36002219A",
"primary": true
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": "096003543",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiting, IN
- Foot and Ankle Pain Clinic Corporation
- Foot and Ankle Pain Clinic Corporation
- Susan Joan Foundos-Biegel, DDS
- David Fried, D.M.D
- Efren Alejandro Gomez, O.D.
- Olga Grbich, RPH
- Huzaifa Haider, DPM
- Hammond Community Ambulatory Care Center L.L.C.
- Hearts Full of Love Consulting & Homecare (Personal Care Services)LLC
- Hendricks County Hospital (Hammond-Whiting Care Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.