Active NPI
Gary D Thal, MD
- Anesthesiology Physician
- Northbrook, IL
National Provider Identifier
1770526071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 77798
- Practice address
- 1 Astellas Way
Northbrook, IL 60062-6111 - Phone
- (224) 205-5278
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 77798 | MA | Primary |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 77798 | MA |
Addresses
Primary practice location
1 Astellas Way
Northbrook, IL 60062-6111
Mailing address
1 Astellas Way
Northbrook, IL 60062-6111
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77798 | MA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395878400000",
"number": "1770526071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 ASTELLAS WAY",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600626111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 ASTELLAS WAY",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600626111",
"telephone_number": "224-205-5278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAL",
"first_name": "GARY",
"middle_name": "D",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-14",
"last_updated": "2014-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "77798",
"primary": true
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "MA",
"license": "77798",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.