Search › Illinois › 172V00000X
Michael Gordon
NPI 1275981805 · on the registry since 2016
Practice
- Address
- 659 E Jefferson St
Freeport, IL 61032 - Phone
- (815) 229-1999
- Fax
- (708) 478-6387
- Organisation at this address
- Presence Life Connections
Citadel At Saint Joseph Village LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 172V00000X
172V00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-05-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois