Gurneectd LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

GURNEECTD LLC

Practice address

3930 Washington St
Gurnee, IL 60031-5702

Phone

(847) 623-4888

NPI assigned

Sep 16, 2021

Organization subpart

No

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

Authorized official

Name

Mitch Weiland

Title

Assistant Controller

Phone

(608) 343-0818

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1699445031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 EXCELSIOR DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537171900",
            "telephone_number": "608-833-2212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 WASHINGTON ST",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600315702",
            "telephone_number": "847-623-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURNEECTD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "WEILAND",
        "authorized_official_first_name": "MITCH",
        "authorized_official_title_or_position": "ASSISTANT CONTROLLER",
        "authorized_official_telephone_number": "608-343-0818"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurnee School District 56
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• Gurnee Surgicare LLC
• Deborah A. Gust, M.A.
• Alma Guzman, MD
• Ashley Hafertepe, APN
• Charla Aimee Hagel, PA-C
• Laurel Sue Haibeck, LCSW

• Dentist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; 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.