Pediatric Medicine

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036083477 Issued in IL

Legal business name

PEDIATRIC MEDICINE

Practice address

601 W Central Rd
Suite 1
Mt Prospect, IL 60056-2379

Phone

(847) 222-0999

Fax

(847) 203-0203

NPI assigned

Mar 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Gisela Gonzalez, M.D.NPI 1932294618

Title

President

Phone

(224) 616-9749

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Gisela M Gonzalez, M.D.

  • Pediatrics Physician
  • Bloomingdale, IL
  • NPI 1932294618
  NPD (past) Authorized official

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1437458064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FLORENCE DR",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682108",
            "telephone_number": "224-616-9749",
            "fax_number": "630-894-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W CENTRAL RD",
            "address_2": "SUITE 1",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600562379",
            "telephone_number": "847-222-0999",
            "fax_number": "847-203-0203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "GISELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "224-616-9749",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036083477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083477",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Pawlusiewicz, D.D.S.
• PBR Family Consulting, Inc.
• Denise Pearl, NBC-HWC
• Jeffrey Abraham Pearl, MD
• Andrew Michael Peck, MD
• Elizabeth Mora Perez, M.D.
• Donovan Edward Perry
• Jason R Perry, R.PH.
• Kelsey Persels
• Carrie Petrelli, LCSW

• Pediatrics Physician in Mt Prospect, IL
• Providers in Mt Prospect, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.

Verify at the official NPI Registry.