Active NPI
Susan Gwodz, FNP
- Family Nurse Practitioner
- Joliet, IL
National Provider Identifier
1356974786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 209024181
- Practice address
- 333 Madison St
Joliet, IL 60435-8200 - Phone
- (815) 725-7133
- NPI assigned
- Feb 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 041.305772 | IL | |
| Family Nurse Practitioner | 363LF0000X | 209024181 | IL | Primary |
Addresses
Primary practice location
333 Madison St
Joliet, IL 60435-8200
Mailing address
24812 Fieldbrook Dr
Plainfield, IL 60544-2876
Phone (815) 616-0501
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041.305772 | IL | MD | Emergency Medical Services (Emergency Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1356974786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24812 FIELDBROOK DR",
"city": "PLAINFIELD",
"state": "IL",
"postal_code": "605442876",
"telephone_number": "815-616-0501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 MADISON ST",
"city": "JOLIET",
"state": "IL",
"postal_code": "604358200",
"telephone_number": "815-725-7133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GWODZ",
"first_name": "SUSAN",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-13",
"last_updated": "2022-02-09",
"certification_date": "2022-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "IL",
"license": "041.305772",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209024181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joliet, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.