Individual
SHINA KEAONIS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3743 HIGHLAND AVE # 2001, DOWNERS GROVE, IL 60515-1594
(630) 719-5454
(630) 719-1263
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209013602
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277-002521
IL
Other
Enumeration date
03/24/2016
Last updated
12/12/2024
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