Gordon, Leanna Lyn

Gordon, Leanna Lyn is an individual health care provider with primary practice located at 641 W 63Rd St , Chicago IL 60621-2032. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine is her primary health care specialty. Gordon, Leanna Lyn can be contacted via phone (773) 388-1600.

Contact Information

Primary practice address
641 W 63Rd St Chicago IL 60621-2032
Phone: (773) 388-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X DOS-1675 Hawaii
Allopathic & Osteopathic Physicians / General Practice 208D00000X DOS-1675 Hawaii
Allopathic & Osteopathic Physicians / Public Health & General Preventive Medicine 2083P0901X 036.162996 Illinois

Profile Details

NPI number 1689012742
LBN Legal business name Gordon, Leanna Lyn
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2013
Last updated May 1st, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689012742 NPPES
Illinois MEDICAID 036162996

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