Gavin Scoliosis and Spine Center, LLC

Primary specialty

OrthotistTaxonomy code 222Z00000X

Legal business name

GAVIN SCOLIOSIS AND SPINE CENTER, LLC

Practice address

1010 Jorie Blvd Ste 24
Oak Brook, IL 60523-4450

Phone

(630) 573-4424

Fax

(620) 573-4424

NPI assigned

Jul 17, 2019

Organization subpart

No

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

Authorized official

Name

Thomas Gavin, CO, LONPI 1114580107

Title

President

Phone

(630) 573-7777

Specialties & licenses 1

Addresses

Other names 1

• Gavin Scoliosis and Spine Center, LLC Doing business as

Locations

Practitioners 1

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

• Thomas Gavin, CO/LO

  • Prosthetic/Orthotic Supplier
  • Oak Brook, IL
  • NPI 1114580107
  NPD Authorized official

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1609429836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 JORIE BLVD STE 24",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234450",
            "telephone_number": "630-573-4424",
            "fax_number": "620-573-4424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 JORIE BLVD STE 24",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234450",
            "telephone_number": "630-573-4424",
            "fax_number": "620-573-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAVIN SCOLIOSIS AND SPINE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-573-7777",
        "authorized_official_credential": "CO, LO"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gavin Scoliosis and Spine Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica L Garcia, MD
• Kelly Suzanne Garcia, BSN, RN, FNP-BC
• Isaiah V Gardiner
• Beth Gasaway, LCPC
• Samanthia Gaspar
• Thomas Gavin, CO/LO
• Tanja Gavrilovic, DNP,APRN,CNP,PMHNPBC
• Genesis Orthopedics & Sports Medicine LLC
• Ravi George, D.O.
• James F Gianakakis, D.D.S.,M.S.

• Orthotist in Oak Brook, IL
• Providers in Oak Brook, IL by specialty
• Orthotist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.