Douglas Gill MD SC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036068005 Issued in IL

Legal business name

DOUGLAS GILL MD SC

Practice address

217 55TH St
Clarendon HLS, IL 60514-1525

Phone

(630) 850-7520

Fax

(630) 850-7514

NPI assigned

Sep 2, 2005

Last updated

Oct 10, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Arthur Gill, MDNPI 1346439668

Title

President

Phone

(630) 850-7522

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6681/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Douglas A Gill

  • Family Medicine Physician
  • Clarendon Hills, IL
  • NPI 1346439668
  Authorized official Same address or phone

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

{
    "created_epoch": "1125619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1326032426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 55TH ST",
            "city": "CLARENDON HLS",
            "state": "IL",
            "postal_code": "605141525",
            "telephone_number": "630-850-7520",
            "fax_number": "630-850-7514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 55TH ST",
            "city": "CLARENDON HLS",
            "state": "IL",
            "postal_code": "605141525",
            "telephone_number": "630-850-7520",
            "fax_number": "630-850-7514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS GILL MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-02",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "GILL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-850-7522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036068005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02201586",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; 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.