NPI 1023115920

Teresa K Gordon

Practitioner Driver Chicago, IL

Practice location

Address: 3625 S Lake Park Ave #1107, Chicago, IL 60653-1468
Phone: (773) 538-1637

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 172A00000X (IL)

Other Driver providers in Illinois →

Registry record

NPI: 1023115920
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.