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General NPI Number Information
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NPI Number | 1942498209
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Entity Type | Organization
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Legal Business Name | NORTH SHERIDAN FAMILY MEDICINE PC
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Dates
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Enumeration Date | 10/11/2007
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Last Update Date | 03/18/2020
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Provider Practice Location Address
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Address Line | 396 TEMPLE AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1435
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Country | US
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Telephone | 847-432-7830
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Fax | 847-432-7966
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Provider Business Mailing Address
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Address Line | 396 TEMPLE AVE
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City | HIGHLAND PARK
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State | IL
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Zip | 60035-1435
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Country | US
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Telephone | 847-432-7830
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Fax | 847-432-7966
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Authorized Official
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Title or Position | OWNER/M.D.
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Name | DR. JULIA GORELIK
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Credential | M.D.
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Telephone | 847-432-7830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036071566
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License Number State | IL
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