Individual provider Active NPI

Yuliya Olegovna Gofman, PA-C

  • Physician Assistant
  • Arlington Heights, IL
National Provider Identifier
1821839291
Registry record updated Sep 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.010326 Issued in IL
Practice address
3030 W Salt Creek LN
Arlington Heights, IL 60005-5001
Phone
(847) 870-4200
Fax
(847) 870-0059
NPI assigned
Jun 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.010326 IL Primary

Addresses

Primary practice location

3030 W Salt Creek LN
Arlington Heights, IL 60005-5001

Mailing address

3030 W Salt Creek LN
Arlington Heights, IL 60005-5001
Phone (847) 704-0190

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
I20250121002938 IL Practitioner - Physician Assistant 7911436969 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Dermatology and Aesthetic Surgery LTDGroup PAC ID 3476736844, 2 clinicians

Practice addresses (Care Compare)

1 S210 Summit Ave
Oak Brook, IL 60181-3933
Phone (630) 282-6004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1717200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1821839291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-704-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 W SALT CREEK LN",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600055001",
            "telephone_number": "847-870-4200",
            "fax_number": "847-870-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFMAN",
        "first_name": "YULIYA",
        "middle_name": "OLEGOVNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-01",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.010326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

Verify at the official NPI Registry.