Individual provider Active NPI

Andrew Gorecki

  • Addiction (Substance Use Disorder) Counselor
  • Skokie, IL
National Provider Identifier
1720510308
Registry record updated Apr 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12078 Issued in IL
Practice address
8707 Skokie Blvd Ste 207
Skokie, IL 60077-2272
Phone
(847) 673-8577
Fax
(847) 568-0411
NPI assigned
Apr 1, 2017
Last updated
Apr 1, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12078 IL Primary

Addresses

Primary practice location

8707 Skokie Blvd Ste 207
Skokie, IL 60077-2272

Mailing address

3207 N Clark St
Chicago, IL 60657-1623
Phone (847) 673-8577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12078ILMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1491004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491004800000",
    "number": "1720510308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3207 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571623",
            "telephone_number": "847-673-8577",
            "fax_number": "847-568-0411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8707 SKOKIE BLVD STE 207",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600772272",
            "telephone_number": "847-673-8577",
            "fax_number": "847-568-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORECKI",
        "first_name": "ANDREW",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-01",
        "last_updated": "2017-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "12078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2017; 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.