Neal J Gordon Edd SC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.002067 Issued in IL

Legal business name

NEAL J GORDON EDD SC

Practice address

4105 Rutgers LN
Northbrook, IL 60062-2911

Phone

(708) 383-4671

NPI assigned

Aug 27, 2015

Organization subpart

No

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

Authorized official

Name

Neal GordonNPI 1235169335

Title

President

Phone

(847) 668-1164

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Neal J Gordon, ED.D.

  • Psychologist
  • Oak Park, IL
  • NPI 1235169335
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1861869646",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 RUTGERS LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622911",
            "telephone_number": "708-383-4671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAL J GORDON EDD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "NEAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-668-1164"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.002067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Elaine Navarette
• Isabel Inez Navarro, M.S.
• Megan Navarro
• Nkem Ndem
• Patrick Wanyoike Ndungu, PHARMD
• Deanna Ned, PSY.D.
• Jenna C Neeley
• Amanda Neill
• Yuliya Nekhai, RBT-20-146120
• Sheila Odonnell Nelson, SLP

• Clinical Psychologist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.