Individual provider Active NPI

Nisha Gokhale, M.D.

  • Psychiatry Physician
  • Oak Lawn, IL
National Provider Identifier
1679913768
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036.137983 Issued in IL
Practice address
10735 S Cicero Ave Ste 100
Oak Lawn, IL 60453-6210
Phone
(708) 636-2211
NPI assigned
Jul 3, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 036.137983 IL Primary

Addresses

Primary practice location

10735 S Cicero Ave Ste 100
Oak Lawn, IL 60453-6210

Mailing address

10735 S Cicero Ave Ste 100
Oak Lawn, IL 60453-6210
Phone (708) 636-2211

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151014001004 IL Practitioner - Psychiatry 9335458355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sudhir M Gokhale MD SCGroup PAC ID 7517923246, 12 clinicians

Practice addresses (Care Compare)

10735 S Cicero Ave
Suite 100
Oak Lawn, IL 60453-6210
Phone (708) 636-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.137983ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sudhir M Gokhale MD SC Psychiatry CurrentSince Oct 12, 2015 Accepting new patients

Locations

10522 S Cicero Ave
Ste 2D
Oak Lawn, IL 60453
Phone (708) 636-2211

10522 S Cicero Ave
Oak Lawn, IL 60453
Phone (708) 424-7106

10522 S Cicero Ave
#2D
Oak Lawn, IL 60453

10735 S Cicero Ave
Ste 100
Oak Lawn, IL 60453
Phone (708) 581-5866

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1679913768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10735 S CICERO AVE STE 100",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604536210",
            "telephone_number": "708-636-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10735 S CICERO AVE STE 100",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604536210",
            "telephone_number": "708-636-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOKHALE",
        "first_name": "NISHA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036.137983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.