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NPI Code Detail

MEDICARE: JOERISSA GEARLDS PA-C

MEDICARE: JOERISSA GEARLDS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantIL
2363A00000XPhysician Assistant0110011306VA

General Provider Information

NPI Number : 1154958544
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOERISSA GEARLDS PA-C
Provider Business Mailing Address
First Line : 1701 N MENARD AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-4120
Country : US
Telephone Number : 773-759-1701
Fax Number :
Provider Business Practice Location Address
First Line : 1775 TYSONS BLVD STE 300
Second Line :
City : MC LEAN
State : VA
Zip : 22102-4285
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2020
Last Update Date : 01/06/2026

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Directions to “ JOERISSA GEARLDS PA-C” Practice Location

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