Individual provider Active NPI

Gail Gannon, APN-CNP

  • Nurse Practitioner
  • Mokena, IL
National Provider Identifier
1639502230
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
277001307 Issued in IL
Practice address
9697 191St St Ste 100
Mokena, IL 60448-8609
Phone
(630) 646-6540
Fax
(306) 646-6542
NPI assigned
Aug 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277001307 IL
Nurse Practitioner 363L00000X 277001307 IL Primary

Addresses

Primary practice location

9697 191St St Ste 100
Mokena, IL 60448-8609

Mailing address

180 Harvester Dr
Suite 110
Burr Ridge, IL 60527-7594
Phone (773) 834-7857

Other practice location 1

Minute Clinic Diagnostic of Illinois
1305 N. Randall Rd.
Crystal Lake, IL 60014-1447
Phone (815) 356-0386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204000329 IL Practitioner - Nurse Practitioner 9436388956 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Practice addresses (Care Compare)

2650 Ridge Ave
Evanston, IL 60201-1700

Merit-based Incentive Payment System (MIPS)

Final score
84.9 of 100Reported as group
Quality
75.91
Promoting interoperability
99
Improvement activities
40
Cost
74.6

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277001307ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Korwitts Chiropractic PC CurrentSince Jun 28, 2021 Accepting new patients
Edward Health Ventures CurrentSince Jul 15, 2023 Accepting new patients
Minuteclinic Diagnostic of Illinois PLLC Family CurrentSince Oct 6, 2021 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 6, 2024 Accepting new patients
Endeavor Health Medical Group CurrentSince Feb 6, 2024 Accepting new patients
Edward Health Ventures CurrentSince Jul 15, 2023 Accepting new patients

Locations

1130 S Veterans Pkwy
Bloomington, IL 61704
Phone (309) 661-1839

9532 Eagle Way
Chicago, IL 60678

1305 Randall Rd
Crystal Lake, IL 60014
Phone (815) 261-1221

2736 Maple Ave
Downers Grove, IL 60515
Phone (630) 963-0080

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Ste 1223
Evanston, IL 60201
Phone (847) 982-3175

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

11200 Lincoln Hwy
Mokena, IL 60448
Phone (815) 464-2171

9697 191st St
Ste 100
Mokena, IL 60448
Phone (630) 646-6540

120 Spalding Dr
Ste 101
Naperville, IL 60540
Phone (630) 527-7730

120 Spalding Dr
Ste 310
Naperville, IL 60540
Phone (630) 527-5575

2045 Plum Grove Rd
Rolling Meadows, IL 60008
Phone (847) 303-2450

Interoperability endpoints

  • Direct secure messaging: ggannonapn114523@uchospital.direct-ci.com
  • Direct secure messaging: ggannon262075@direct.edward.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1639502230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 HARVESTER DR",
            "address_2": "SUITE 110",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605277594",
            "telephone_number": "773-834-7857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9697 191ST ST STE 100",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604488609",
            "telephone_number": "630-646-6540",
            "fax_number": "306-646-6542"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Minute Clinic Diagnostic of Illinois",
            "address_2": "1305 N. Randall Rd.",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600141447",
            "country_code": "US",
            "telephone_number": "815-356-0386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANNON",
        "first_name": "GAIL",
        "credential": "APN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-19",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277001307",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "277001307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

Verify at the official NPI Registry.