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NPI Code Detail

MEDICARE: GEORGIANA ELIZABETH GOMORCZAK PA-C

MEDICARE: GEORGIANA ELIZABETH GOMORCZAK 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
1363AM0700XMedical Physician Assistant085.011757IL

General Provider Information

NPI Number : 1770440935
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGIANA ELIZABETH GOMORCZAK PA-C
Provider Business Mailing Address
First Line : 2359 BURR OAK AVE
Second Line :
City : NORTH RIVERSIDE
State : IL
Zip : 60546-1319
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5311 S HARLEM AVE STE 100
Second Line :
City : CHICAGO
State : IL
Zip : 60638-1006
Country : US
Telephone Number : 773-992-1555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/08/2026

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Directions to “ GEORGIANA ELIZABETH GOMORCZAK PA-C” Practice Location

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