Active NPI
Gregory Shergold
- Counselor
- Chicago, IL
National Provider Identifier
1467812677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 178.010098
- Practice address
- 4152 N Keystone Ave
Chicago, IL 60641-2436 - Phone
- (773) 283-9071
- Fax
- (773) 283-9185
- NPI assigned
- Mar 1, 2016
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 178.010098 | IL | Primary |
Addresses
Primary practice location
4152 N Keystone Ave
Chicago, IL 60641-2436
Mailing address
4152 N Keystone Ave
Chicago, IL 60641-2436
Phone (773) 283-9071
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 178.010098 | IL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lutheran Social Services of Illinois | 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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Chicago, IL
- NPI 1073724563
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456790400000",
"number": "1467812677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4152 N KEYSTONE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606412436",
"telephone_number": "773-283-9071",
"fax_number": "773-283-9185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4152 N KEYSTONE AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606412436",
"telephone_number": "773-283-9071",
"fax_number": "773-283-9185"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHERGOLD",
"first_name": "GREGORY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-03-01",
"last_updated": "2016-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "IL",
"license": "178.010098",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
- Taras Sheremeta
- Michael Gregor Sherenian, M.D.
- Renslow Sherer, M.D.
- Anant Kaur Shergill, CCC-SLP
- Ardaman Shergill
- Sheridan Cardiac Consultants, S.C.
- Sheridan Counseling Group PC
- Sheridan Medical Center, S.C
- Sheridan Shores Care & Rehabilitation Center
- Sheridan Village Nursing and Rehabilitation Center LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.