Wayne R Gavino, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

3653891 Issued in IL

Practice address

860 Summit St
Suite 254
Elgin, IL 60120-4339

Phone

(847) 695-8721

Fax

(847) 695-8755

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Conchita G Gavino MD SC

  • Psychiatry Physician
  • Elgin, IL
  • NPI 1134153133
  NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578597571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "SUITE 254",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204339",
            "telephone_number": "847-695-8721",
            "fax_number": "847-695-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 SUMMIT ST",
            "address_2": "SUITE 254",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601204339",
            "telephone_number": "847-695-8721",
            "fax_number": "847-695-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVINO",
        "first_name": "WAYNE",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": "3653891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "3653891",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Garica-Desjarlait, EI
• Renukadevi P Garla, MD
• Jamie Garrard
• Amanda Rose Garza
• Conchita G Gavino, MD
• Jessica Gavzer, PA-C
• Shelly Jo Gehrke, LCSW
• Barb J Gembica-Bue, RN
• General and Vascular Surgery, LTD.
• Genoa Healthcare LLC

• Neurology Physician in Elgin, IL
• Providers in Elgin, IL by specialty
• Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.