Gustavo Vonderlancken, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036109409 Issued in IL

Practice address

2044 Madison Ave
Suite 27
Granite City, IL 62040-4641

Phone

(618) 451-7600

NPI assigned

Oct 18, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

General Surgery

Education

Kansas City College of Medicine and Surgery, 1998

Medicare assignment

May accept Medicare assignment

Group practices

Ahs Il Medical Group LLCGroup PAC ID 5496111676, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gateway Regional Medical Center Hospital, Granite City, IL, CCN 140125

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gvonderl@yourcarecommunity.org
• Direct secure messaging: gustavo.vonderlancken.1@28328.direct.athenahealth.com

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.

• Ahs Il Medical Group LLC

  • Clinic/Center
  • Granite City, IL
  • NPI 1659098101
  Medicare reassignment Care Compare group NPD
• Granite City Physicians Corp

  • Clinical Medical Laboratory
  • Granite City, IL
  • NPI 1508983214
  NPD (past)

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

• American Healthcare Systems Illinois LLC

  • General Acute Care Hospital
  • Granite City, IL
  • NPI 1326765884
  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Glen Carbon, IL
  • NPI 1700586344

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Edwardsville, IL
  • NPI 1760182307

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Clinic/Center
  • Waterloo, IL
  • NPI 1770283301

  Hospital

  Care Compare affiliation
• American Healthcare Systems Illinois LLC

  • Urgent Care Clinic/Center
  • Columbia, IL
  • NPI 1982304523

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1881683282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 MADISON AVE",
            "address_2": "SUITE 27",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404641",
            "telephone_number": "618-451-7600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 MADISON AVE",
            "address_2": "SUITE 27",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404641",
            "telephone_number": "618-451-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VONDERLANCKEN",
        "first_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036109409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109409",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Renee Verbeke, RN
• Jeremie J Veto, PHARM D.
• Tanya Vietmeier, PTA
• Village Family Dental, LLC
• Vna Homecare, Inc.
• Corey Voss, PT
• Walgreen Co
• Walgreen Co
• Chloe Abigail Wallace, LSW
• Valencia Wallace

• Surgery Physician in Granite City, IL
• Providers in Granite City, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.