Individual provider Active NPI

Cynthia Lee Gordon, MD

  • Psychiatry Physician
  • Northbrook, IL
National Provider Identifier
1992961643
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
036123560 Issued in IL
Practice address
3320 Dundee Rd
Northbrook, IL 60062-2303
Phone
(847) 892-7910
Fax
(847) 892-7911
NPI assigned
Aug 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 125-049660 IL
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 036123560 IL Primary

Addresses

Primary practice location

3320 Dundee Rd
Northbrook, IL 60062-2303

Mailing address

6615 Grand Ave Ste 390
Gurnee, IL 60031-4591
Phone (847) 212-1015

Other identifiers 2

IdentifierTypeStateIssuer
036123560MedicaidIL
F400491295MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090901000049 IL Practitioner - PsychiatryPractitioner - Addiction Medicine 7517012347 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Addiction Medicine
Education
Rush Medical College of Rush University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3320 Dundee Rd
Northbrook, IL 60062-2303
Phone (847) 892-7909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036123560ILMDPsychiatry Physician
125-049660ILMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Professionals Health Program, LLC Multi-Specialty CurrentSince Jul 1, 2017 Accepting new patients

Locations

701 Lee St
Ste 125
Des Plaines, IL 60016
Phone (847) 892-7910

6615 Grand Ave
Gurnee, IL 60031
Phone (224) 402-3738

3320 Dundee Rd
Northbrook, IL 60062
Phone (847) 226-7741

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1217548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1992961643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6615 GRAND AVE STE 390",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600314591",
            "telephone_number": "847-212-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622303",
            "telephone_number": "847-892-7910",
            "fax_number": "847-892-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "CYNTHIA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-01",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "125-049660",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036123560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036123560",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F400491295",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

Verify at the official NPI Registry.