Individual
TORY GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8755 S CORNELL AVE, CHICAGO, IL 60617-2705
(773) 875-3978
Mailing address
8755 S CORNELL AVE, CHICAGO, IL 60617-2705
(773) 875-3978
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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