Provider Demographics
NPI:1912277237
Name:GORSKI CHIROPRACTIC CENTER S C
Entity Type:Organization
Organization Name:GORSKI CHIROPRACTIC CENTER S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:R
Authorized Official - Last Name:GORSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-393-6699
Mailing Address - Street 1:2S517 STATE ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:WARRENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60555-1254
Mailing Address - Country:US
Mailing Address - Phone:630-393-6699
Mailing Address - Fax:630-393-6760
Practice Address - Street 1:2S517 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:WARRENVILLE
Practice Address - State:IL
Practice Address - Zip Code:60555-1254
Practice Address - Country:US
Practice Address - Phone:630-393-6699
Practice Address - Fax:630-393-6760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-03
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-005745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02290031OtherBCBS
IL02290031OtherBCBS