Gooseberry Inc.

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

GOOSEBERRY INC.

Practice address

5632 Virginia Ave
Clarendon Hills, IL 60514-1517

Phone

(224) 832-0121

NPI assigned

Nov 21, 2019

Organization subpart

No

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

Authorized official

Name

Gene Kruhly, PT, DPT

Title

Director

Phone

(224) 836-0121

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1639715949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5632 VIRGINIA AVE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141517",
            "telephone_number": "224-832-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 VIRGINIA AVE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "605141517",
            "telephone_number": "224-832-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOSEBERRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "KRUHLY",
        "authorized_official_first_name": "GENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "224-836-0121",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan E. Fox, MA, LCPC
• Mary Ann Gasior, P.T.
• Douglas A Gill
• Mar Ellen Ellen Glazier
• Ronald W. Goers, D.D.S.
• Amy Griffin, MHS, CCC-SLP/L
• Kara Haakonson, DACCHM
• Philip James Hamel, DMD
• William Bryan Hamel III, D.D.S.
• Mary Beth Hastings, R.D.H.

• All providers in Clarendon Hills, IL
• Rehabilitation Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.