Gordon, Neal J

Gordon, Neal J is an sole proprietor health care provider with primary practice located at 433 Wisconsin Ave , Oak Park IL 60302-3688. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Gordon, Neal J can be contacted via phone (708) 383-4671.

Contact Information

Primary practice address
433 Wisconsin Ave Oak Park IL 60302-3688
Fax: (847) 714-1165
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 071-002067 Illinois

Profile Details

NPI number 1235169335
LBN Legal business name Gordon, Neal J
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 4th, 2006
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235169335 NPPES
Illinois Other 02272834 BLUECROSS PREFERRED PROV.

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