Caitlin Gordon
Dentist in Maywood, IL. Individual provider (NPI-1).
NPI number1619816196
StatusActive
Last updated in NPPESJul 27, 2026
Details
- NPI
- 1619816196
- Entity type
- Individual (NPI-1)
- Name
- Caitlin Gordon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 27, 2026
- Certification date
- Jul 27, 2026
- Last updated
- Jul 27, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 018.012563 | IL | Yes |
Practice location
2160 S 1st AveMaywood, IL 60153-3328
Phone 888-584-7888
Mailing address
403 7th St SwAustin, MN 55912-2559
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