Organization · NPI-2

Gordon Health Foundation

Clinic/Center · Grayslake, IL

NPI number1356053227
StatusActive
Last updated in NPPESDec 22, 2022

Details

NPI
1356053227
Entity type
Organization (NPI-2)
Legal business name
Gordon Health Foundation
Organization subpart
No
Enumeration date
Dec 22, 2022
Certification date
Dec 21, 2022
Last updated
Dec 22, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center––Yes

Practice location

106 Center St
Grayslake, IL 60030-1533

Phone 850-294-8948

Mailing address

1282 Chesterfield Ln
Grayslake, IL 60030-3797

Phone 850-294-8948

Authorized official

Stephanie Gordon
Executive Director
8502948948

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