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NPI Code Detail

MEDICARE: DR. ANDREW GORCHYNSKY M.D.

MEDICARE: DR. ANDREW GORCHYNSKY M.D.
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
1208600000XSurgery Physician036-057660IL

General Provider Information

NPI Number : 1730100173
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW GORCHYNSKY M.D.
Provider Business Mailing Address
First Line : 1300 LEE RD
Second Line :
City : NORTHBROOK
State : IL
Zip : 60062-3809
Country : US
Telephone Number : 773-327-3141
Fax Number :
Provider Business Practice Location Address
First Line : 3538 W FULLERTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-2443
Country : US
Telephone Number : 773-327-3141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 02/23/2011

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