Holly L Gunderson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036062769 Issued in IL

Practice address

330 Madison St
Suite 104
Joliet, IL 60435-6565

Phone

(815) 725-3440

Fax

(815) 725-7209

NPI assigned

Jun 10, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277251200000",
    "number": "1891737557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MADISON ST",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356565",
            "telephone_number": "815-725-3440",
            "fax_number": "815-725-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MADISON ST",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356565",
            "telephone_number": "815-725-3440",
            "fax_number": "815-725-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "HOLLY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036062769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036062769",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maria Guerrero
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• Ankita Gummadi
• Samindi Malika Gunasekara, M.D.
• Megan Gunier
• Allison Gunnink, MBA, LPMT, MT-BC
• Atul N Gupta, MD
• Samir K Gupta, M.D.
• Aaron Gurfinchel, MD

• Surgery Physician in Joliet, IL
• Providers in Joliet, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; 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.