Active NPI
Alexis De Gale, DVM
- Special Hospital
- Elk Grove Village, IL
National Provider Identifier
1902210164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Special Hospital
- License
- 090011280
- Practice address
- 1050 Bonaventure Dr
Elk Grove Village, IL 60007-3277 - Phone
- (847) 584-0200
- NPI assigned
- Jun 16, 2014
- 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 |
|---|---|---|---|---|
| Special Hospital | 284300000X | 090011280 | IL | Primary |
Addresses
Primary practice location
1050 Bonaventure Dr
Elk Grove Village, IL 60007-3277
Mailing address
1050 Bonaventure Dr
Elk Grove Village, IL 60007-3277
Phone (847) 584-0200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 090011280 | Other | IL | IL DVM LICENSE NUMBER |
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 |
|---|---|---|---|
| 090011280 | IL | MD | Special Hospital |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1902210164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 BONAVENTURE DR",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073277",
"telephone_number": "847-584-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 BONAVENTURE DR",
"city": "ELK GROVE VILLAGE",
"state": "IL",
"postal_code": "600073277",
"telephone_number": "847-584-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE GALE",
"first_name": "ALEXIS",
"name_prefix": "Dr.",
"credential": "DVM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-06-16",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "284300000X",
"taxonomy_group": "",
"desc": "Special Hospital",
"state": "IL",
"license": "090011280",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL DVM LICENSE NUMBER",
"identifier": "090011280",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove Village, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.