Gabriel Gino Menna, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301513153 Issued in MI

Practice address

7638 N Milwaukee Ave
Niles, IL 60714-3133

Phone

(833) 515-7200

NPI assigned

Jun 14, 2022

Reactivated

Apr 6, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Paperclip Health

  • Addiction Medicine (Family Medicine) Physician
  • Niles, IL
  • NPI 1114759917
  NPD

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1386374247",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "102 CAMOMILE ST",
            "city": "WOODBRIDGE",
            "state": "ONTARIO",
            "postal_code": "L4L 8S1"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7638 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143133",
            "telephone_number": "833-515-7200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7702 N Alpine RD",
            "address_purpose": "LOCATION",
            "city": "Loves Park",
            "state": "IL",
            "postal_code": "61111",
            "country_code": "US",
            "telephone_number": "815-971-3397",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENNA",
        "first_name": "GABRIEL",
        "middle_name": "GINO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "deactivation_date": "2023-03-06",
        "reactivation_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301513153",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0077486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medax Medical Supply Inc
• Medline Medical Supply Inc
• Mega Medical Supply, Inc.
• Meghan a Erwin, LCSW, PLLC
• Laura Mell
• Melissa A Meredith, PHARM.D.
• Nick Alan Mester
• Meyer Family Medicine Associates LLC
• Alexander Matthew Meyer, PSY.D.
• Michael John Meyer, D.O.

• Family Medicine Physician in Niles, IL
• Providers in Niles, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.