Individual
MR. BRETT MICHAEL GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7300 191ST ST, TINLEY PARK, IL 60487-9361
(815) 806-3211
(815) 806-3221
Mailing address
7300 191ST ST, TINLEY PARK, IL 60487-9361
(815) 806-3211
(815) 806-3221
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051-039100
IL
Other
Enumeration date
06/17/2011
Last updated
06/17/2011
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