Neal J Gordon, ED.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

071-002067 Issued in IL

Practice address

433 Wisconsin Ave
Oak Park, IL 60302-3688

Phone

(708) 383-4671

Fax

(847) 714-1165

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Neal J Gordon Edd SC

  • Clinical Psychologist
  • Northbrook, IL
  • NPI 1861869646
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235169335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 RUTGERS LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622911",
            "telephone_number": "847-714-1164",
            "fax_number": "847-714-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 WISCONSIN AVE",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603023688",
            "telephone_number": "708-383-4671",
            "fax_number": "847-714-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "NEAL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071-002067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS PREFERRED PROV.",
            "identifier": "02272834",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vanessa Gonzalez
• Lavette Goodman Graham, PMHNP-BC
• Ikesha Goodwin
• Christina Marie Gordon, FNP-BC
• Diane Toby Gordon, MSW
• Goso Consulting, Inc.
• Stacey A Gottlieb, MSW
• Cathleen M Gould, M.D.
• Cynthia Lauren Gould, M.D.
• Sarah Rose Gould

• Psychologist in Oak Park, IL
• Providers in Oak Park, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.