Individual
THERESA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3002 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8268
Mailing address
3457 SHERIDAN RD APT 111, ZION, IL 60099-4336
(773) 954-9546
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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