Gerald J Mingolelli, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

036085438 Issued in IL

Practice address

17850 Kedzie Ave
3200
Hazel Crest, IL 60429-2058

Phone

(708) 798-8112

Fax

(708) 798-9016

NPI assigned

Jul 5, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Olympia Fields Internal Medicine

  • Family Medicine Physician
  • Flossmoor, IL
  • NPI 1336170844
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1508863531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 967",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604770967",
            "telephone_number": "708-532-6029",
            "fax_number": "708-532-6095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE",
            "address_2": "3200",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292058",
            "telephone_number": "708-798-8112",
            "fax_number": "708-798-9016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINGOLELLI",
        "first_name": "GERALD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036085438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036085438",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Family and Community Resources PC
• Sandra Lynn Mikulich, APN
• Melanie Doreen Miller, M.A.
• Mindful Expressions PLLC
• Gina M Minga, APRN, ACCNS-BC
• Mariam Tariq Mir, M.D.
• Satya M Mishra, MD
• Monique Montgomery
• Elise S Mooney, DPT
• Deshon T Moore, M.D.

• Gastroenterology Physician in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Gastroenterology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.