Individual
DR. MICHAEL EDWARD GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
635 CHICAGO AVE, EVANSTON, IL 60202
(847) 491-0880
(847) 491-0014
Mailing address
1841 W 47TH ST, CHICAGO, IL 60609-3844
(847) 491-0880
(847) 491-0014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1916382
IL
Other
Enumeration date
05/19/2006
Last updated
12/02/2015
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