Individual provider Active NPI

Gabriela Gonzalez, PA-C

  • Physician Assistant
  • Warrenville, IL
National Provider Identifier
1790449056
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008819 Issued in IL
Practice address
4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone
(630) 352-5450
Fax
(630) 933-4959
NPI assigned
Oct 23, 2021
Last updated
Jun 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085008819 IL Primary
Surgical Physician Assistant 363AS0400X 085.008819 IL

Addresses

Primary practice location

4405 Weaver Pkwy
Warrenville, IL 60555-3269

Mailing address

4405 Weaver Pkwy
Warrenville, IL 60555-3269
Phone (630) 352-5450

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220803000868 IL Practitioner - Physician Assistant 8729460001 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085008819ILMDPhysician Assistant
085.008819ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center Single Specialty CurrentSince Jul 1, 2022 Accepting new patients
The University of Chicago Medical Center CurrentSince Jul 1, 2022 Accepting new patients
Northwestern Medical Faculty Foundation Single Specialty CurrentSince Feb 26, 2024 Accepting new patients
University of Chicago Single Specialty CurrentSince Jul 1, 2022 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

Dept 5777
Carol Stream, IL 60122

675 N Saint Clair St
Ste 19-100
Chicago, IL 60611
Phone (312) 664-3278

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

4405 Weaver Pkwy
Warrenville, IL 60555
Phone (630) 352-5450

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1634947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1790449056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-933-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 WEAVER PKWY",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553269",
            "telephone_number": "630-352-5450",
            "fax_number": "630-933-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GABRIELA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-23",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008819",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.008819",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

Verify at the official NPI Registry.