Henry Jay Gault, M.D.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

03646462 Issued in IL

Practice address

770 Lake Cook Rd
Suite 250
Deerfield, IL 60015-4920

Phone

(847) 267-0001

Fax

(847) 267-0002

NPI assigned

Dec 11, 2007

Last updated

Dec 11, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jan 9, 2014 through Jan 9, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Apex Performance Consulting, Inc.

  • Exercise & Sports Psychologist
  • Deerfield, IL
  • NPI 1841658820
  NPD (past)
• Dr. Jeffrey a. Fishbein, Psy.D, P.C

  dba Dr. Gault, Fishbein, and Associates

  • Psychologist
  • Deerfield, IL
  • NPI 1831321082
  NPD (past)

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197331200000",
    "number": "1417130527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 LAKE COOK RD",
            "address_2": "SUITE 250",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154920",
            "telephone_number": "847-267-0001",
            "fax_number": "847-267-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 LAKE COOK RD",
            "address_2": "SUITE 250",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154920",
            "telephone_number": "847-267-0001",
            "fax_number": "847-267-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAULT",
        "first_name": "HENRY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "03646462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Edward Galliani
• Mikhail Galperin, MD
• Tatyana Galperin, MD
• Walter Genaro Garcia Hernandez, PSYD
• Kristine Antoinette Gargiulo
• Susan J Gault, PSYD
• Megan Elizabeth Gaumond Oval
• Sophie Gelman
• Gentle Home Services, Inc.
• Lindsey Gercken, CCC-SLP

• Child & Adolescent Psychiatry Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.