Individual
SAMANTHA CLAIRE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1765 N ELSTON AVE STE 110, CHICAGO, IL 60642-1501
(773) 276-1100
(773) 276-1102
Mailing address
1765 N ELSTON AVE STE 110, CHICAGO, IL 60642-1501
(773) 276-1100
(773) 276-1102
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
36151568
IL
207NP0225X
Pediatric Dermatology Physician
Primary
036151568
IL
Other
Enumeration date
06/07/2016
Last updated
08/24/2022
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