Individual provider Active NPI

Debe Gonzales, BSN RN

  • Registered Nurse
  • Niles, IL
National Provider Identifier
1568847291
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
041292911 Issued in IL
Practice address
8310 N Olcott Ave
Niles, IL 60714-2520
Phone
(847) 663-1705
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041292911 IL Primary

Addresses

Primary practice location

8310 N Olcott Ave
Niles, IL 60714-2520

Mailing address

8310 N Olcott Ave
Niles, IL 60714-2520
Phone (847) 663-1705

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
041292911ILMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437609600000",
    "number": "1568847291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8310 N OLCOTT AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607142520",
            "telephone_number": "847-663-1705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8310 N OLCOTT AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607142520",
            "telephone_number": "847-663-1705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "DEBE",
        "credential": "BSN RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041292911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.