NPIMap

Individual provider Active NPI

Gilbert Gulbrandson, CO

  • Orthotist
  • Cary, IL
National Provider Identifier
1881770733
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
License
213000033 Issued in IL
Practice address
2615 Three Oaks Rd
Suite 2B
Cary, IL 60013
Phone
(847) 639-4140
Fax
(847) 639-4140
NPI assigned
Oct 31, 2006
Last updated
Oct 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X 213000033 IL Primary

Addresses

Primary practice location

2615 Three Oaks Rd
Suite 2B
Cary, IL 60013

Mailing address

2615 Three Oaks Rd
Suite 2B
Cary, IL 60013
Phone (847) 639-4140

Other identifiers 1

IdentifierTypeStateIssuer
364056537001MedicaidIL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
213000033ILMDOrthotist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1881770733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 THREE OAKS RD",
            "address_2": "SUITE 2B",
            "city": "CARY",
            "state": "IL",
            "postal_code": "60013",
            "telephone_number": "847-639-4140",
            "fax_number": "847-639-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 THREE OAKS RD",
            "address_2": "SUITE 2B",
            "city": "CARY",
            "state": "IL",
            "postal_code": "60013",
            "telephone_number": "847-639-4140",
            "fax_number": "847-639-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULBRANDSON",
        "first_name": "GILBERT",
        "name_prefix": "Mr.",
        "credential": "CO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "IL",
            "license": "213000033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "364056537001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.