Provider Demographics
NPI:1194068460
Name:GOROVOY, DAVID SOROUSH (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SOROUSH
Last Name:GOROVOY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:676 N SAINT CLAIR ST STE 800
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2978
Mailing Address - Country:US
Mailing Address - Phone:312-695-3696
Mailing Address - Fax:312-695-5645
Practice Address - Street 1:676 N SAINT CLAIR ST STE 800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2978
Practice Address - Country:US
Practice Address - Phone:312-695-3696
Practice Address - Fax:312-695-5645
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY546092085R0202X
TX506832085R0202X
IL0361483022085R0202X
CT663942085R0202X
NY2946862085R0202X
FLME1516272085R0202X
NV244892085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology