Individual
GORDON MESA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, FNP-BC
Contact information
Practice address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 766-1949
Mailing address
3134 N CLARK ST, CHICAGO, IL 60657-4414
(773) 766-1949
(773) 766-4908
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277000201
IL
Other
Enumeration date
11/03/2015
Last updated
04/19/2022
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