Active NPI
Gittel Mindick, PA-C
- Physician Assistant
- Cicero, IL
National Provider Identifier
1740555044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085.004706
- Practice address
- 6001 W Cermak Rd
Cicero, IL 60804-2018 - Phone
- (708) 656-5230
- NPI assigned
- Mar 20, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085.004706 | IL | Primary |
| Physician Assistant | 363A00000X | PA9106302 | FL | |
| Physician Assistant | 363A00000X | 015325-1 | NY |
Addresses
Primary practice location
6001 W Cermak Rd
Cicero, IL 60804-2018
Mailing address
6001 W Cermak Rd
Cicero, IL 60804-2018
Phone (708) 656-5230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015325-1 | NY | MD | Massage Therapist |
| PA9106302 | FL | MD | Physician Assistant |
| 085.004706 | IL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1402876800000",
"number": "1740555044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6001 W CERMAK RD",
"city": "CICERO",
"state": "IL",
"postal_code": "608042018",
"telephone_number": "708-656-5230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 W CERMAK RD",
"city": "CICERO",
"state": "IL",
"postal_code": "608042018",
"telephone_number": "708-656-5230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINDICK",
"first_name": "GITTEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-20",
"last_updated": "2014-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085.004706",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9106302",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "015325-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cicero, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.