Ruthie Celestine Gavin, FNP-BC

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

041.322139 Issued in IL

Practice address

12251 S 80TH Ave
Palos Heights, IL 60463

Phone

(630) 257-1111

Fax

(630) 257-1115

NPI assigned

Feb 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1205393014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE STE 1630",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "604631256",
            "telephone_number": "708-923-5173",
            "fax_number": "708-923-5018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12251 S 80TH AVE",
            "city": "PALOS HEIGHTS",
            "state": "IL",
            "postal_code": "60463",
            "telephone_number": "630-257-1111",
            "fax_number": "630-257-1115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4609 W Spencer Ln",
            "address_purpose": "LOCATION",
            "city": "Alsip",
            "state": "IL",
            "postal_code": "608032766",
            "country_code": "US",
            "telephone_number": "773-297-6779 x77329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "RUTHIE",
        "middle_name": "CELESTINE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.019276",
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "IL",
            "license": "041.322139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roxanna Melissa Garcia, M.D.
• Vaughan Garrigan, FNP
• Jonathan Clavecillas Gaspar, PT
• Tylor Lawrence Gauger, DDS
• Uma Devi Gavani, MD
• Sally A Gaw, M.S. CCC/SLP
• Ryan Jon Gawron, D.C
• Marikay T Gazda, LCSW
• Christopher Miracle Gbunnor
• Ellen Fay Geddes, PSYD.

• Home Health Registered Nurse in Palos Heights, IL
• Providers in Palos Heights, IL by specialty
• Home Health Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.