Gabisa Medical Chicago PLLC

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

GABISA MEDICAL CHICAGO PLLC

Doing business as

Gabisa Medical PLLC

Practice address

1449 W Irving Park Rd
Chicago, IL 60613-1922

Phone

(718) 697-8378

Fax

(888) 929-2371

NPI assigned

Jan 24, 2021

Organization subpart

No

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

Authorized official

Name

Marcelo Venegas-Pizarro, MD

Title

Medical Director

Phone

(347) 524-1914

Specialties & licenses 1

Addresses

Other names 1

• Gabisa Medical PLLC Doing business as

Electronic endpoints 1

Tax ID family

Gabisa Medical Chicago PLLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Gabisa Medical Chicago PLLC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1104563121
  NPD tax ID
• Gabisa Medical Chicago PLLC

  • Community Health Clinic/Center
  • Chicago, IL
  • NPI 1821765140
  NPD tax ID
• Gabisa Medical Chicago PLLC

  • Primary Care Clinic/Center
  • Chicago, IL
  • NPI 1922745942
  NPD tax ID

Locations

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

{
    "created_epoch": "1611446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611446400000",
    "number": "1952991838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3436 CLINTON AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604023322",
            "telephone_number": "347-524-1914",
            "fax_number": "888-929-2371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1449 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606131922",
            "telephone_number": "718-697-8378",
            "fax_number": "888-929-2371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GABISA MEDICAL CHICAGO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-24",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-24",
        "status": "A",
        "authorized_official_last_name": "VENEGAS-PIZARRO",
        "authorized_official_first_name": "MARCELO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "347-524-1914",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Chicago",
            "affiliation": "N",
            "endpointDescription": "Data serving with DOH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1449 W Irving Park Rd",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606131922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gabisa Medical PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael James Gaber, AGACNP-BC
• Rikki Gaber, MA, MS, CGC
• Gabisa Medical Chicago PLLC
• Gabisa Medical Chicago PLLC
• Gabisa Medical Chicago PLLC
• Jessica Gable, MS, OTR/L
• Melissa Gabler, DO
• Princess Gabor, MA, LPC
• Ahmed Mahmoud Mohamed Gabr, MBBCH
• Lauren Gabra

• Community Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Community Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; 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.