Gisela M Gonzalez, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036083477 Issued in IL

Practice address

109 Fairfield Way Ste 103
Bloomingdale, IL 60108-1522

Phone

(630) 894-1054

Fax

(630) 894-3280

NPI assigned

Oct 4, 2006

Last updated

Dec 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatric Medicine

  • Pediatrics Physician
  • Mount Prospect, IL
  • NPI 1437458064
  NPD (past) Authorized official
• Bloomingdale General Pediatrics

  • Pediatrics Physician
  • Bloomingdale, IL
  • NPI 1295822120
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1932294618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 FLORENCE DR",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600682108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FAIRFIELD WAY STE 103",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601081522",
            "telephone_number": "630-894-1054",
            "fax_number": "630-894-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "GISELA",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036083477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "30-0482979",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083477",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Gattuso LCSW LLC
• Jessica Giuffre, LCPC
• Glendale Psychological Services
• Gloria Caruso M.D.P.C
• Michael S Goetter, LCPC
• Tatiana Granados, LSW, LCSW
• Green Harmony Group Inc.
• Deborah Green, CNM
• Greg E Sharon MD SC (Asthma and Allergy Center)
• Jessica Grudsky, R.D., L.D.N.

• Pediatrics Physician in Bloomingdale, IL
• Providers in Bloomingdale, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; 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.