Gabriel Mendoza, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

043110552 Issued in IL

Practice address

7101 N Cicero Ave Ste 202
Lincolnwood, IL 60712-2143

Phone

(773) 433-6210

Fax

(866) 744-0950

NPI assigned

Sep 8, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672704000000",
    "number": "1881315794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7101 N CICERO AVE STE 202",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122143",
            "telephone_number": "773-433-6210",
            "fax_number": "866-744-0950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 N CICERO AVE STE 202",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122143",
            "telephone_number": "773-433-6210",
            "fax_number": "866-744-0950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6303 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606601203",
            "country_code": "US",
            "telephone_number": "773-270-1652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDOZA",
        "first_name": "GABRIEL",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-08",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "IL",
            "license": "043110552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medicure Care LTD
• Gabriela Medina
• Medstar Lab Inc
• Donna Melody, COTA/L
• Alexandra Mendoza
• Amanda Weimer Merin, OTR/L
• Meritcare Home Health Inc
• Edward Meyer, LCSW
• Midwest Dry Eye Center LLC
• Midwest Medical Physicians LLC

• Licensed Practical Nurse in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Licensed Practical Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.