Individual provider Active NPI

Alba Mariner Gonzalez

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1922655331
Registry record updated Aug 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
240 E Huron St Ste 1-200
Chicago, IL 60611-2909
Phone
(312) 503-7975
NPI assigned
Aug 20, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

240 E Huron St Ste 1-200
Chicago, IL 60611-2909

Mailing address

240 E Huron St Ste 1-200
Chicago, IL 60611-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20230427000566 WA Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 9638534670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1922655331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 E HURON ST STE 1-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E HURON ST STE 1-200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112909",
            "telephone_number": "312-503-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINER GONZALEZ",
        "first_name": "ALBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.