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General NPI Number Information
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NPI Number | 1790468866
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Entity Type | Individual
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Provider Name | KARINA COVARRUBIAS GORGEY
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 1620 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3801
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Country | US
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Telephone | 312-947-1150
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Fax |
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Provider Business Mailing Address
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Address Line | 2828 N TALMAN AVE
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City | CHICAGO
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State | IL
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Zip | 60618-7846
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Country | US
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Telephone | 773-916-9065
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 209033742
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041438083
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License Number State | IL
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