Gurnee Pediatrics, S.C.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036046907 Issued in IL

Legal business name

GURNEE PEDIATRICS, S.C.

Practice address

15 Tower CT
Suite 150
Gurnee, IL 60031

Phone

(847) 623-4464

Fax

(847) 623-9984

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Faye C. Master, MD

Title

Co Owner

Phone

(847) 623-4464

Specialties & licenses 1

Addresses

Other names 1

• Gabriel Pediatrics, S.C. Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Dante Polintan Gabriel, MD

  • Pediatrics Physician
  • Gurnee, IL
  • NPI 1437247673
  NPD (past)
• Alma Guzman, MD

  • Pediatrics Physician
  • Gurnee, IL
  • NPI 1366530503
  NPD (past)
• Faye S Montes, MD

  • Pediatrics Physician
  • Gurnee, IL
  • NPI 1811085053
  NPD (past)
• Marson Tenoso, MD

  • Pediatrics Physician
  • Gurnee, IL
  • NPI 1891944666
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625788800000",
    "number": "1568569754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 TOWER CT",
            "address_2": "SUITE 150",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "60031",
            "telephone_number": "847-623-4464",
            "fax_number": "847-623-9984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 TOWER CT",
            "address_2": "SUITE 150",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "60031",
            "telephone_number": "847-623-4464",
            "fax_number": "847-623-9984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURNEE PEDIATRICS, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A",
        "authorized_official_last_name": "MASTER",
        "authorized_official_first_name": "FAYE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "847-623-4464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036046907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gabriel Pediatrics, S.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gurnee Counseling Center
• Gurnee Dental Arts
• Gurnee Dental Care, LLC
• Gurnee Eye Care, P.C.
• Gurnee Orthodontics LLC
• Gurnee Physical Medicine LTD
• Gurnee Radiology Center, LLC
• Gurnee School District 56
• Gurnee Stone Medical Center P.C
• Gurnee Stone Medical Center PC

• Pediatrics Physician in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.