Philip Benjamin Gorelick, MD

Primary specialty

Vascular Neurology PhysicianTaxonomy code 2084V0102X

License

036.056869 Issued in IL

Practice address

259 E Erie St
Chicago, IL 60611-2987

Phone

(312) 926-6000

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/684/brand/2/csg/43/fhir/r4

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.

• Bonaventure Medical Foundation, LLC

  • Family Medicine Physician
  • Elk Grove Village, IL
  • NPI 1588775647
  NPD (past)
• Lakefront Medical Associates LLC

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1144418633
  NPD (past)
• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  NPD (past)
• Trinity Health - Michigan

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1902002272
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545436800000",
    "number": "1902841273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 N. LAKE SHORE DRIVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-695-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "49503",
            "country_code": "US",
            "telephone_number": "616-685-5050",
            "fax_number": "616-685-8962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORELICK",
        "first_name": "PHILIP",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2018-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "036-056869",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "MI",
            "license": "4301100015",
            "primary": false
        },
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "IL",
            "license": "036.056869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tatia M Gore
• Veronica Gore
• Maria Elzbieta Gorecka
• Mariam Goreish, MD
• Gleb Henri Gorelick, MD
• Sasha Nicole Gorelik, MD
• Goren Eye Associates, SC
• Matthew Brent Goren, M.D.
• Blair Jaclyn Gorenberg, SLP
• Marsha Elaine Gorens, M.D.

• Vascular Neurology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Vascular Neurology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2018; 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.