Active NPI
Mikalei Yelena Gordon, MD
- Psychiatry Physician
- Chicago, IL
National Provider Identifier
1851895940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 036.153747
- Practice address
- 25 E Washington St Ste 1820
Chicago, IL 60602-1831 - Phone
- (847) 834-9164
- NPI assigned
- Mar 22, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 036.153747 | IL | Primary |
Addresses
Primary practice location
25 E Washington St Ste 1820
Chicago, IL 60602-1831
Mailing address
25 E Washington St Ste 1820
Chicago, IL 60602-1831
Phone (847) 834-9164
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 22, 2023 through May 22, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.153747 | IL | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663459200000",
"number": "1851895940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 E WASHINGTON ST STE 1820",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021831",
"telephone_number": "847-834-9164"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 E WASHINGTON ST STE 1820",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606021831",
"telephone_number": "847-834-9164"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "MIKALEI",
"middle_name": "YELENA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-03-22",
"last_updated": "2022-09-18",
"certification_date": "2022-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": "036.153747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2022; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.