Organization Active NPI

Go Gastroenterology LTD

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1396328985
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GO GASTROENTEROLOGY LTD
Practice address
3004 N Ashland Ave
Chicago, IL 60657-3012
Phone
(773) 871-4600
NPI assigned
Apr 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Patrick Foley
Title
Executive Director
Phone
(847) 975-8901

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

3004 N Ashland Ave
Chicago, IL 60657-3012

Mailing address

3004 N Ashland Ave
Chicago, IL 60657-3012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210526001587 IL Part B Supplier - Clinic/Group Practice 5991104804 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1396328985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3004 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 N ASHLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573012",
            "telephone_number": "773-871-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GO GASTROENTEROLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "FOLEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "847-975-8901"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.