Individual
DR. NEAL J GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ED.D.
Contact information
Practice address
433 WISCONSIN AVE, OAK PARK, IL 60302-3688
(708) 383-4671
(847) 714-1165
Mailing address
4105 RUTGERS LN, NORTHBROOK, IL 60062-2911
(847) 714-1164
(847) 714-1165
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071-002067
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02272834
BLUECROSS PREFERRED PROV.
IL
Enumeration date
07/04/2006
Last updated
07/08/2007
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