Individual provider Active NPI

Gjulshana Nurceski, PA

  • Physician Assistant
  • Willowbrook, IL
National Provider Identifier
1497313381
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085008844 Issued in IL
Practice address
40 75TH St
Willowbrook, IL 60527-2325
Phone
(630) 581-5372
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 1407812308 NC
Physician Assistant 363A00000X 085008844 IL Primary

Addresses

Primary practice location

40 75TH St
Willowbrook, IL 60527-2325

Mailing address

PO Box 337
Conover, NC 28613-0337
Phone (828) 994-4570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220823003185 IL Practitioner - Physician Assistant 1153704168 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Practice addresses (Care Compare)

2201 Oak Park Ave
Berwyn, IL 60402-2220
Phone (312) 324-0222

4211 N Cicero Ave
Chicago, IL 60641-1651
Phone (773) 794-1000

5300 S Long Ave
Chicago, IL 60638-2918
Phone (312) 300-7400

800 W Plainfield Rd
Countryside, IL 60525-3745
Phone (708) 298-0543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1407812308NCMDInternal Medicine Physician
085008844ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Express Care 2, Inc CurrentSince Jul 14, 2022 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jul 14, 2022 Accepting new patients
BL Price Jr Medical Consultants Internal Medicine PastSince Apr 1, 2016 Accepting new patients

Locations

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1497313381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "CONOVER",
            "state": "NC",
            "postal_code": "286130337",
            "telephone_number": "828-994-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 75TH ST",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605272325",
            "telephone_number": "630-581-5372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NURCESKI",
        "first_name": "GJULSHANA",
        "name_prefix": "Miss",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "1407812308",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085008844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

Verify at the official NPI Registry.