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Individual

TALIA SIVAN GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2500 W HIGGINS RD STE 1040, HOFFMAN ESTATES, IL 60169-2049
(847) 884-8096
(847) 490-0978
Mailing address
PO BOX 734240, CHICAGO, IL 60673-4240
(815) 744-8554
(630) 495-1770

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009132
IL
390200000X
Student in an Organized Health Care Education/Training Program
023491
NY

Other

Enumeration date
04/02/2020
Last updated
11/14/2022
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