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Dmitri Gordon
NPI 1518216191 · on the registry since 2012 · sole proprietor
Practice
- Address
- 820 S Damen St
Chicago, IL 60612 - Phone
- (312) 250-5459
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 282N00000X
282N00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2012-08-29
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