Individual
MICHAEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9401 N HAMLIN AVE, NILES, IL 60714-5869
(847) 493-8669
Mailing address
3807 GREENWOOD ST, SKOKIE, IL 60076-1939
(773) 428-0275
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
402651
IL
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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