Individual
DR. JUSTIN R GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3143 W DEVON AVE, CHICAGO, IL 60659-1424
(773) 764-5300
(773) 764-2810
Mailing address
3143 W DEVON AVE, CHICAGO, IL 60659-1424
(773) 764-5300
(773) 764-2810
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046006849
IL
Other
Enumeration date
08/01/2006
Last updated
07/07/2011
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