Individual provider Active NPI

Rachel Sara Gordezky

  • Clinical Pathology/Laboratory Medicine Physician
  • Maywood, IL
National Provider Identifier
1942543020
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
License
036161654 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X MD045300 DC
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X MD045300 DC
Student in an Organized Health Care Education/Training Program 390200000X
Clinical Pathology/Laboratory Medicine Physician 207ZP0105X 036161654 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

2041 Georgia Ave NW Ste 1-400
Washington, DC 20060-0001
Phone (202) 865-6100

Other practice location 1

1740 W Taylor St
Chicago, IL 60612-7232
Phone (866) 600-2273

Other practice location 2

2041 Georgia Ave NW Ste 1-400
Washington, DC 20060
Phone (202) 865-6100

Other practice location 3

2041 Georgia Ave NW Ste 1-400
Washington, DC 20060
Phone (202) 865-6100

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address RGORDEZKY164444@DIRECT.LUHS.ORG Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816000907 IL Practitioner - Pathology 3971812132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD045300DCMDClinical Pathology/Laboratory Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jul 15, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Jul 15, 2022 Accepting new patients
Loyola University Medical Center Current Accepting new patients

Locations

1740 W Taylor St
Chicago, IL 60612
Phone (312) 355-4000

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1942543020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 GEORGIA AVE NW STE 1-400",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200600001",
            "telephone_number": "202-865-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1740 W Taylor St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606127232",
            "country_code": "US",
            "telephone_number": "866-600-2273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Georgia Ave NW Ste 1-400",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20060",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2041 Georgia Ave NW Ste 1-400",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20060",
            "country_code": "US",
            "telephone_number": "202-865-6100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDEZKY",
        "first_name": "RACHEL",
        "middle_name": "SARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "DC",
            "license": "MD045300",
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "DC",
            "license": "MD045300",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZP0105X",
            "taxonomy_group": "",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": "IL",
            "license": "036161654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "RGORDEZKY164444@DIRECT.LUHS.ORG",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2160 S 1st Ave",
            "city": "Maywood",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601533328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.