Active NPI
Bernadette Ann Gates, OTR
- General Acute Care Hospital
- Crystal Lake, IL
National Provider Identifier
1881895787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Acute Care Hospital
- License
- 056.006590
- Practice address
- 5150 Northwest Hwy
Crystal Lake, IL 60014-8058 - Phone
- (847) 842-4167
- NPI assigned
- May 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Acute Care Hospital | 282N00000X | 056.006590 | IL | Primary |
Addresses
Primary practice location
5150 Northwest Hwy
Crystal Lake, IL 60014-8058
Mailing address
416 McHenry Ave
Crystal Lake, IL 60014-7147
Phone (815) 260-0131
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
| License | State | Type | Specialty |
|---|---|---|---|
| 056.006590 | IL | MD | General Acute Care Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1881895787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 MCHENRY AVE",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147147",
"telephone_number": "815-260-0131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5150 NORTHWEST HWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600148058",
"telephone_number": "847-842-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GATES",
"first_name": "BERNADETTE",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-29",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": "IL",
"license": "056.006590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.