Gordon, Paul James

Gordon, Paul James is an individual health care provider with primary practice located at 10604 Southwest Hwy Ste 101 , Chicago Ridge IL 60415. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Gordon, Paul James can be contacted via phone (708) 346-4065.

Contact Information

Primary practice address
10604 Southwest Hwy Ste 101 Chicago Ridge IL 60415
Phone: (708) 346-4065
Fax: (708) 423-5799
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 01046920A Indiana
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 036095321 Illinois

Profile Details

NPI number 1356341994
LBN Legal business name Gordon, Paul James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2005
Last updated Nov 5th, 2018 - about 6 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 1356341994 NPPES
Illinois MEDICAID 036095321
Illinois MEDICAID 200144230F
Illinois MEDICAID 200144230C
Illinois MEDICAID 1356341994
Illinois MEDICAID 200144230A
Illinois MEDICAID 200144230B

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