Individual
MR. BRUCE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
778 FRONTAGE RD, SUITE 115, NORTHFIELD, IL 60093-1209
(312) 282-1200
Mailing address
778 FRONTAGE RD, SUITE 115, NORTHFIELD, IL 60093-1209
(312) 282-1200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149009456
IL
Other
Enumeration date
07/22/2009
Last updated
07/22/2009
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