Active NPI
Dante Polintan Gabriel, MD
- Pediatrics Physician
- Gurnee, IL
National Provider Identifier
1437247673
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036046907
- Practice address
- 15 Tower CT
Suite 150
Gurnee, IL 60031 - Phone
- (847) 623-4464
- Fax
- (847) 623-9984
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036046907 | IL | Primary |
Addresses
Primary practice location
15 Tower CT
Suite 150
Gurnee, IL 60031
Mailing address
15 Tower CT
Suite 150
Gurnee, IL 60031
Phone (847) 623-4464
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036046907 | Medicaid | IL |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036046907 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gurnee Pediatrics, S.C. | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Gurnee, IL
- NPI 1568569754
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318550400000",
"number": "1437247673",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 TOWER CT",
"address_2": "SUITE 150",
"city": "GURNEE",
"state": "IL",
"postal_code": "60031",
"telephone_number": "847-623-4464",
"fax_number": "847-623-9984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 TOWER CT",
"address_2": "SUITE 150",
"city": "GURNEE",
"state": "IL",
"postal_code": "60031",
"telephone_number": "847-623-4464",
"fax_number": "847-623-9984"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABRIEL",
"first_name": "DANTE",
"middle_name": "POLINTAN",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2011-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036046907",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036046907",
"state": "IL"
}
],
"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 Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.