Individual
JONATHAN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1725 W HARRISON ST STE 1159, CHICAGO, IL 60612-3883
(214) 999-9999
Mailing address
1725 W HARRISON ST STE 1159, CHICAGO, IL 60612-3883
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036165225
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
06/20/2023
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