NPIMap

Individual provider Active NPI

Gary B Harris, M.D.

  • Emergency Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1245339944
Registry record updated Oct 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036061845 Issued in IL
Practice address
111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Phone
(414) 290-6720
Fax
(414) 290-6755
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036061845 IL Primary

Addresses

Primary practice location

111 E Wisconsin Ave
Milwaukee, WI 53202-4815

Mailing address

3000 Woodcreek Dr
Downers Grove, IL 60515-5401
Phone (630) 874-2994

Other identifiers 2

IdentifierTypeStateIssuer
036061845MedicaidIL
P00822024OtherILRAILROAD MEDICARE

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Emergency Medicine Specialists, LLC Past Accepting new patients
Emergency Care Physician Services-Blue Island LTD Emergency Medicine Past Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Emergency Care Physician Services Emergency Medicine Past Accepting new patients
Ihc-Swedishamerican Emergency Physicians, LLC Emergency Medicine PastSince Dec 15, 2019 Accepting new patients
Health Dynamics, LLC Past Accepting new patients
Acute Care Specialists II, LTD Emergency Medicine Past Accepting new patients
Midway Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Unimed, LTD Past Accepting new patients
United Occupational Medicine and Walk in Services, LLC Emergency Medicine Past Accepting new patients
Tri-County Emergency Physicians, LTD Emergency Medicine Past Accepting new patients
Emergency Department Associates, P.C. Emergency Medicine Past Accepting new patients
Southern Wisconsin Emergency Associates SC Emergency Medicine Past Accepting new patients

Organizations & group practices 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1245339944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 WOODCREEK DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155401",
            "telephone_number": "630-874-2994",
            "fax_number": "630-968-1622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "GARY",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036061845",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036061845",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00822024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.