Active NPI
Garrett Hauck, MD
- Surgery Physician
- Chicago, IL
National Provider Identifier
1245827195
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125081963
- Practice address
- 840 S Wood St
Chicago, IL 60612-4325 - Phone
- (312) 996-6765
- NPI assigned
- Dec 27, 2020
- Last updated
- Nov 5, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125081963 | IL | Primary |
Addresses
Primary practice location
840 S Wood St
Chicago, IL 60612-4325
Mailing address
2317 W Taylor St Apt 1R
Chicago, IL 60612-4213
Phone (609) 402-1206
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230710000817 | IL | Order and Referring Only - General Surgery | 6608235601 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125081963 | IL | MD | Surgery Physician |
Interoperability endpoints
- ghauck151073@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699142400000",
"number": "1245827195",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2317 W TAYLOR ST APT 1R",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124213",
"telephone_number": "609-402-1206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 S WOOD ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606124325",
"telephone_number": "312-996-6765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUCK",
"first_name": "GARRETT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-12-27",
"last_updated": "2023-11-05",
"certification_date": "2023-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125081963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.