Individual provider Active NPI

Gaye Desiree Koconis, CNM

  • Advanced Practice Midwife
  • Wilmette, IL
National Provider Identifier
1447361787
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209004570 Issued in IL
Practice address
328 Linden Ave
Wilmette, IL 60091-2895
Phone
(847) 475-1224
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 209004570 IL Primary

Addresses

Primary practice location

328 Linden Ave
Wilmette, IL 60091-2895

Mailing address

328 Linden Ave
Wilmette, IL 60091-2895
Phone (847) 475-1224

Other practice location 1

2500 Ridge Ave
Evanston, IL 60201-2455
Phone (847) 475-1224

Other practice location 2

2550 Compass Rd Ste J
Glenview, IL 60026-1610
Phone (847) 998-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240725000064 IL Practitioner - Certified Nurse Midwife (CNM) 4284170358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002
Medicare assignment
May accept Medicare assignment
Group practices
Together Women'S Health Medical Group of Illinois, PLLCGroup PAC ID 8325195506, 26 clinicians

Practice addresses (Care Compare)

328 Linden Ave
Wilmette, IL 60091-2895
Phone (847) 475-1224

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209004570ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Together Women'S Health Medical Group of Illinois, PLLC CurrentSince Apr 29, 2024 Accepting new patients
North Shore Associates in Gynecology and Obstetrics, S.C. Past Accepting new patients

Locations

900 N Kingsbury St
Ste 130N
Chicago, IL 60610
Phone (312) 775-1100

2550 Compass Rd
Ste J
Glenview, IL 60026
Phone (847) 998-9600

Interoperability endpoints

  • Direct secure messaging: gaye.koconis.1@29023.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1447361787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 LINDEN AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912895",
            "telephone_number": "847-475-1224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 LINDEN AVE",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600912895",
            "telephone_number": "847-475-1224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602012455",
            "country_code": "US",
            "telephone_number": "847-475-1224",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2550 Compass Rd Ste J",
            "address_purpose": "LOCATION",
            "city": "Glenview",
            "state": "IL",
            "postal_code": "600261610",
            "country_code": "US",
            "telephone_number": "847-998-9600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOCONIS",
        "first_name": "GAYE",
        "middle_name": "DESIREE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209004570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmette, IL

Sources for this page

Verify at the official NPI Registry.