Provider Demographics
NPI:1538325147
Name:GORMAN, JULIE TOPIC (DO)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:TOPIC
Last Name:GORMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELIZABETH
Other - Last Name:TOPIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 E CONGRESS PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6284
Mailing Address - Country:US
Mailing Address - Phone:815-356-5050
Mailing Address - Fax:
Practice Address - Street 1:350 E CONGRESS PKWY STE C
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6284
Practice Address - Country:US
Practice Address - Phone:815-356-5050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-03
Last Update Date:2019-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361308842084P0800X
IL1250546262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry