Smita Gautam, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

36135521 Issued in IL

Practice address

8 S Michigan Ave FL 10
Chicago, IL 60603-3357

Phone

(312) 609-5300

NPI assigned

Aug 2, 2011

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: thefamilyinstituteatnorthwesternuniversity.smitagautam@142202.advancedmd-direct.com

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.

• Larc

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Lansing, IL
  • NPI 1245695733
  NPD (past)

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

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1447538871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 S MICHIGAN AVE FL 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033357",
            "telephone_number": "312-609-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S MICHIGAN AVE FL 10",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033357",
            "telephone_number": "312-609-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "SMITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "36135521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janay Gause
• Megan Gauss
• Gagan Gautam, MD, MCH
• Jennifer Gautam
• Mehul Gautam
• Margaret T Smith Gauthier, P.T.
• Matthew L Gauthier, DPT
• Grace Florence Gautier
• Thomas Gavagan, MPH
• Yaritza Gavidia-Paris

• All providers in Chicago, IL
• Child & Adolescent Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.