Individual
STEPHANIE CHRISTINE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2216 20TH ST, ZION, IL 60099-1648
(847) 445-4633
Mailing address
3315 98TH PL, PLEASANT PRAIRIE, WI 53158-5702
(517) 410-9288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.109586
IL
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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