Individual provider Active NPI

Kim J Gehle, MD

  • Pediatrics Physician
  • Wheaton, IL
National Provider Identifier
1760400592
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036147489 Issued in IL
Practice address
2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055
Phone
(630) 653-5115
Fax
(630) 653-4493
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 036147489 IL Primary

Addresses

Primary practice location

2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055

Mailing address

2001 N Gary Ave Ste 100
Wheaton, IL 60187-3055
Phone (630) 653-5115

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
I20181025000354 IL Practitioner - Pediatric Medicine 3971529330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Toledo College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Dupage Physician GroupGroup PAC ID 5890696231, 1,087 clinicians

Practice addresses (Care Compare)

2001 N Gary Ave
Wheaton, IL 60187-3264
Phone (630) 614-4000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036147489ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Dupage Physician Group CurrentSince Oct 17, 2018 Accepting new patients
Central Dupage Physician Group Pediatrics CurrentSince Oct 17, 2018 Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

2001 N Gary Ave
Wheaton, IL 60187
Phone (630) 614-4100

2001 N Gary Ave
Ste 100
Wheaton, IL 60187
Phone (630) 614-4100

1800 N Main St
Wheaton, IL 60187
Phone (630) 469-0045

Organizations & group practices 2

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1760400592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N GARY AVE STE 100",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873055",
            "telephone_number": "630-653-5115",
            "fax_number": "630-653-4493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEHLE",
        "first_name": "KIM",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036147489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.