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1184886517 NPI number — DR. GREGG MARTIN DELOSSANTOS

NPI Number: 1184886517
Health Care Provider/Practitioner: DR. GREGG MARTIN DELOSSANTOS

Information about “1184886517” NPI (DR. GREGG MARTIN DELOSSANTOS) exists in 1184886517 in HTML format HTML  |  1184886517 in plain Text format TXT  |  1184886517 in PDF (Portable Document Format) PDF  |  1184886517 in an XML format XML  formats.

NPI Number : 1184886517 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184886517",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DELOSSANTOS",
    "FirstName": "GREGG",
    "MiddleName": "MARTIN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "39671 TREASURY CTR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60694-9600",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-533-5500",
    "MailingAddressFaxNumber": "773-533-0945",
    "FirstLinePracticeLocationAddress": "2839 W MADISON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60612-1925",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-533-5500",
    "PracticeLocationAddressFaxNumber": "773-533-0945",
    "EnumerationDate": "06/26/2008",
    "LastUpdateDate": "04/07/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "213ES0103X",
        "TaxonomyName": "Foot & Ankle Surgery Podiatrist",
        "LicenseNumber": "016005158",
        "LicenseNumberStateCode": "IL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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