Jamie Lynne Gordon, LAT, ATC
Specialist/Technologist, Athletic Trainer in Chicago, IL. Individual provider (NPI-1).
NPI number1982304101
StatusActive
Last updated in NPPESMar 7, 2023
Details
- NPI
- 1982304101
- Entity type
- Individual (NPI-1)
- Name
- Jamie Lynne Gordon
- Credential
- LAT, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 7, 2023
- Certification date
- May 18, 2021
- Last updated
- Mar 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 096.005339 | IL | Yes |
Practice location
501 S WabashChicago, IL 60605
Phone 312-341-2100
Mailing address
501 S WabashChicago, IL 60605
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