Individual
JASON R GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
(773) 792-7921
Mailing address
7435 W TALCOTT AVE, CHICAGO, IL 60631-3707
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036148761
IL
Other
Enumeration date
05/18/2016
Last updated
04/23/2019
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