Organization Active NPI

Gerard M. Goshgarian, M.D., S.C.

  • Medical Specialty Clinic/Center
  • Gurnee, IL
National Provider Identifier
1386701415
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
GERARD M. GOSHGARIAN, M.D., S.C.
Practice address
105 N Greenleaf St
Gurnee, IL 60031-3326
Phone
(847) 244-4343
Fax
(847) 244-8111
NPI assigned
Jan 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Linda H. Miller
Title
Office Manager
Phone
(847) 244-4343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X IL Primary

Addresses

Primary practice location

105 N Greenleaf St
Gurnee, IL 60031-3326

Mailing address

105 N Greenleaf St
Gurnee, IL 60031-3326
Phone (847) 244-4343

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386701415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N GREENLEAF ST",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313326",
            "telephone_number": "847-244-4343",
            "fax_number": "847-244-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N GREENLEAF ST",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313326",
            "telephone_number": "847-244-4343",
            "fax_number": "847-244-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERARD M. GOSHGARIAN, M.D., S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-244-4343",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • 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.