NPIMap

Organization Active NPI

GGL Healthcare Associates, PLLC

  • Internal Medicine Physician
  • Skokie, IL
National Provider Identifier
1972215390
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
GGL HEALTHCARE ASSOCIATES, PLLC
Practice address
9933 Lawler Ave Ste 440
Skokie, IL 60077-3720
Phone
(847) 529-5332
NPI assigned
Dec 16, 2022
Last updated
Jan 9, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Authorized official

Name
Boris Gurevich, MDNPI 1902877129
Title
Officer
Phone
(847) 226-5503

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

9933 Lawler Ave Ste 440
Skokie, IL 60077-3720

Mailing address

342 S Milwaukee Ave
Wheeling, IL 60090-5021

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230318000075 IL Part B Supplier - Clinic/Group Practice 0749654572 Receives reassigned benefits from 7 practitioners
Practice locations: Skokie, IL

National Provider Directory

National Provider Directory

Locations

9933 Lawler Ave
Ste 440
Skokie, IL 60077
Phone (224) 251-8490

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673222400000",
    "number": "1972215390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "342 S MILWAUKEE AVE",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600905021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9933 LAWLER AVE STE 440",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600773720",
            "telephone_number": "847-529-5332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GGL HEALTHCARE ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A",
        "authorized_official_last_name": "GUREVICH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "847-226-5503",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.