Theresa L Gorman

Primary specialty

Critical Care Medicine Registered NurseTaxonomy code 163WC0200X

License

041.296842 Issued in IL

Practice address

10829 S Western Ave
Suite B
Chicago, IL 60643-3229

Phone

(773) 779-8200

NPI assigned

Jun 6, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Theresa L Percy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1336587831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 FRAN LIN PKWY",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10829 S WESTERN AVE",
            "address_2": "SUITE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606433229",
            "telephone_number": "773-779-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORMAN",
        "first_name": "THERESA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-06",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "IL",
            "license": "041.296842",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041.296842",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THERESA",
            "last_name": "PERCY",
            "middle_name": "L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Paula Madelyn Gorlitz, PHD
• Adam Benjamin Gorman, MD
• Bridget Gorman, RD
• Jeremiah Gorman
• Kathleen Mary Gorman, MB BCH NUI
• Tiffany Gorman
• Mark Edward Gormley
• Maria Gorneva
• Grant J Gornick
• Lauren Gaye-Osterbrock Gornick, DPT

• Critical Care Medicine Registered Nurse in Chicago, IL
• Providers in Chicago, IL by specialty
• Critical Care Medicine Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.