North Sheridan Family Medicine PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

036071566 Issued in IL

Legal business name

NORTH SHERIDAN FAMILY MEDICINE PC

Practice address

396 Temple Ave
Highland Park, IL 60035-1435

Phone

(847) 432-7830

Fax

(847) 432-7966

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Julia Gorelik, M.D.

Title

Owner/M.D.

Phone

(847) 432-7830

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1942498209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 TEMPLE AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600351435",
            "telephone_number": "847-432-7830",
            "fax_number": "847-432-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 TEMPLE AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600351435",
            "telephone_number": "847-432-7830",
            "fax_number": "847-432-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHERIDAN FAMILY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "GORELIK",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "OWNER/M.D.",
        "authorized_official_telephone_number": "847-432-7830",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036071566",
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071566",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS IL",
            "identifier": "1881794592",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "jeanmcd1991@yahoo.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "396 Temple Ave",
            "city": "Highland Park",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600351435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Specialist in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.