Gurnee Physical Medicine

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

GURNEE PHYSICAL MEDICINE

Practice address

977 Lakeview Pkwy
Suite 190
Vernon Hills, IL 60061-1400

Phone

(847) 932-1079

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Neelesh Patel

Title

Owner

Phone

(847) 932-1079

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306938311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY",
            "address_2": "SUITE 190",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "977 LAKEVIEW PKWY",
            "address_2": "SUITE 190",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611400",
            "telephone_number": "847-932-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURNEE PHYSICAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "NEELESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-932-1079"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Vernon Hills, IL
• Providers in Vernon Hills, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.