DR. JOE GORDON (NPI# 1124199468) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124199468 |
| Entity Type | Individual |
| Full Name | DR. JOE GORDON |
| Credential | D.D.S. |
| Practice Address |
514 N Western Ave Lake Forest IL 60045-1989 |
| Practice Telephone | 8474821900 |
| Practice Fax Number | 8474821909 |
| Mailing Telephone | 8474821900 |
| Mailing Fax Number | 8474821909 |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558389288 | Joe E Gordon | Orthopaedic Surgery | 1 Childrens Pl, Ste 1b, Saint Louis, MO 63110-1002 | 2006-07-18 |
| Street Address |
514 N WESTERN AVE |
| City | LAKE FOREST |
| State | IL |
| Zip Code | 60045-1989 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699218933 | Jana Bricker | Acupuncturist | 514 N Western Ave, Suite B, Lake Forest, IL 60045-1989 | 2016-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
| 1184278640 | Mary Belluomini Dipietro | Dietitian, Registered | 1000 North Westmoreland Rd., Lake Forest, IL 60045 | 2019-08-01 |
| 1336621747 | Brook Elizabeth Orvis | Physical Therapist | 1000 N Westmoreland Road, 2nd Floor, Pavilion B, Lake Forest, IL 60045 | 2018-08-31 |
| 1336621028 | Michelle Nebel | Audiologist | 225 East Deerpath, Suite 223, Lake Forest, IL 60045 | 2018-08-30 |
| 1467951731 | Devan Keesling | Audiologist | 800 N Westmoreland Rd Ste Ll30, Lake Forest, IL 60045 | 2018-02-01 |
| 1023516796 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Westmoreland Rd Ste A, Lake Forest, IL 60045 | 2018-01-29 |
| 1275056780 | Karen Elizabeth Cohen | Counselor | 1331 S. Estate Lane, Lake Forest, IL 60045 | 2017-07-18 |
| 1497281711 | Caroline Connors | Speech-Language Pathologist | 660 Westmoreland Road, Lake Forest, IL 60045 | 2017-05-05 |
| 1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
| 1225424575 | Sean Robert Wessel | Internal Medicine | 1000 N Westmoreland Rd Ste 3556, Lake Forest, IL 60045 | 2015-04-14 |
| Find all providers in zip 60045 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639387079 | Meshia Azad | Dentist | 22855 Lake Forest Dr Ste D, Lake Forest, CA 92630-1647 | 2007-05-18 |
| 1023193596 | Robin Arita | Dentist | 23321 El Toro Rd Ste C, Lake Forest, CA 92630-4825 | 2006-10-25 |
| 1295241164 | Meshia Azad D.d.s. | Dentist | 22855 Lake Forest Dr Ste D, Lake Forest, CA 92630-1647 | 2017-12-14 |
| 1477009454 | Rex Chuang, Dds, Inc. | Dentist | 23321 El Toro Rd, Suite C, Lake Forest, CA 92630-4825 | 2016-08-30 |
| 1497009831 | Keith H Tam Dds Inc | Dentist | 23321 El Toro Rd, Suite C, Lake Forest, CA 92630 | 2012-11-07 |
| 1073730131 | Anokhi Dalia Bock | Dentist | 840 S Waukegan Rd, Suite 107, Lake Forest, IL 60045-2608 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1073125746 | Jessica Mattern Dds, Pllc | Dentist | 326 W Burlington Ave, La Grange, IL 60525-2363 | 2020-08-23 |
| 1568925014 | Southern Illinois Pediatric Dentistry of Edwardsville | Dentist | 1419 Lewis Road, Suite 2, Edwardsville, IL 62025 | 2019-04-11 |
| 1710450754 | Drs Selberg & Rice Pllc | Dentist | 4945 Stone Falls Ctr Ste B, O Fallon, IL 62269-7801 | 2019-01-02 |
| 1821583634 | Dentalgenix | Dentist | 113 E Schaumburg Rd, Schaumburg, IL 60194-3518 | 2018-06-25 |
| 1528562253 | Rachel Vorwaller | Dentist | 1460 N Halsted St Ste 403, Chicago, IL 60642-2607 | 2018-03-19 |
| 1942740006 | Dhwani M. Joshi | Dentist | 195 S Rand Rd Ste 110, Lake Zurich, IL 60047-2205 | 2017-03-08 |
| 1316393390 | Erin Marie Petrik | Dentist | 2530 N Clark St, Apt 203, Chicago, IL 60614-4972 | 2016-05-10 |
| 1669839593 | Algonquin Kids Dentistry, Inc | Dentist | 4097 W Algonquin Rd, Algonquin, IL 60102-9401 | 2016-01-22 |
| 1720468598 | Mehedia Haque | Dentist | 2062 N Milwaukee Ave, Chicago, IL 60647 | 2015-06-05 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 60045 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.