DR. NICOLE MICHELE GASTALA M.D.
NPI 1912260571
Family Medicine in Chicago, IL

Q: What is the provider's specialty?

The provider's specialty is Family Medicine with taxonomy code 207Q00000X.

Active since June 19, 2012PECOS EnrolledAccepts Medicare Assignment

1220 S WOOD ST, CHICAGO, IL 60608(708) 642-6875 Get Directions Write a Review

NPPES record last updated: November 22, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Dr. Nicole Michele Gastala M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. NICOLE MICHELE GASTALA M.D. (NPI 1912260571) is an individual family medicine provider in Chicago, Illinois, licensed in Illinois (036.145379) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with University Of Illinois Hospital And Clinics, and maintains a secondary practice location in Marshalltown.

NPPES Registry Identity

NPI1912260571

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. NICOLE MICHELE GASTALACredential: M.D.

Location Address1220 S WOOD STChicago, IL 60608

Mailing Address1515 S Prairie Ave Unit 1311Chicago, IL 60605-3157 · (708) 642-6875

Phone(708) 642-6875

Sole ProprietorNo

Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2012

Enumeration DateJune 19, 2012

Last NPPES UpdateNovember 22, 2018

✔ NPI 1912260571 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in IL · 036.145379✔ Licensed in IA · 41628

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License R 9515 (IA)

1220 S WOOD ST, Chicago, IL 60608

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Secondary Practice Location 1

Location 1412 E Church StMarshalltown, IA 50158-2947 · Phone (641) 753-4021 · Fax (641) 753-4025

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nicole Michele Gastala M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810130648

PECOS Enrollment IDI20180726001254

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Illinois Hospital And Clinics

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipGovernment - State

CMS Certification Number140150

Location1740 West Taylor St Suite 1400Chicago, IL 60612 · Cook County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60608 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.06 typical visit price

range $60.08 – $183.39

Typical copayment $23.51 (range $15.02 – $45.84)

Most-billed visit code 99203

Established Patient

$105.70 typical visit price

range $18.97 – $148.12

Typical copayment $26.42 (range $4.74 – $37.03)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER COLELLA APN

Nurse Practitioner (Family)