Provider Demographics
NPI:1841620242
Name:PAUL R. GORECKI, PH.D., P.C.
Entity type:Organization
Organization Name:PAUL R. GORECKI, PH.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GORECKI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:847-382-2449
Mailing Address - Street 1:800 S NORTHWEST HWY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-4652
Mailing Address - Country:US
Mailing Address - Phone:847-382-2449
Mailing Address - Fax:847-382-9718
Practice Address - Street 1:800 S. NORTHWEST HWY.
Practice Address - Street 2:SUITE 201
Practice Address - City:BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-4681
Practice Address - Country:US
Practice Address - Phone:847-382-2449
Practice Address - Fax:847-382-9718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.002828103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty