DR. JUSTIN R GORDON (NPI# 1366459711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366459711 |
| Entity Type | Individual |
| Full Name | DR. JUSTIN R GORDON |
| Credential | OD |
| Practice Address |
3143 W Devon Ave Chicago IL 60659-1424 |
| Practice Telephone | 7737645300 |
| Practice Fax Number | 7737642810 |
| Mailing Telephone | 7737645300 |
| Mailing Fax Number | 7737642810 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2011-07-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 046006849 | IL | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225353568 | Justin Stanley Gordon | Dermatology | 450 Broadway St Fl 4, Redwood City, CA 94063-3132 | 2010-03-30 |
| 1265961205 | Justin Gordon | Social Worker | 6624 Jimmy Carter Blvd Ste A, Peachtree Corners, GA 30071-1727 | 2017-06-05 |
| 1205248200 | Justin W Gordon | Specialist/Technologist | 3500 Sw 119th St, Oklahoma City, OK 73170-4500 | 2014-05-24 |
| 1861766586 | Justin Gordon | Marriage & Family Therapist | 640 E 700 S, Suite 201, St George, UT 84770-4023 | 2012-02-27 |
| 1205162674 | Justin E Gordon | Physical Therapist | 1075 Mason Ave, Daytona Beach, FL 32117-4611 | 2009-10-20 |
| Street Address |
3143 W DEVON AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60659-1424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164807434 | Sarrah Malke | Dental Hygienist | 3143 W Devon Ave, Chicago, IL 60659-1424 | 2015-07-28 |
| 1831490911 | Family Care Dental Group, Ltd. | Dentist | 3143 W Devon Ave, Chicago, IL 60659-1424 | 2010-11-05 |
| 1386835528 | Varoujan Dadourian | Dentist | 3143 W Devon Ave, Chicago, IL 60659-1424 | 2007-08-05 |
| 1851440010 | Stacy Olswang | Optometrist | 3143 W Devon Ave, Chicago, IL 60659-1424 | 2007-01-09 |
| 1679641633 | Mark Mkrdichian | Dentist | 3143 W Devon Ave, Chicago, IL 60659-1424 | 2006-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811425 | Devon Homecare Physicians Inc. | Family Medicine | 2822 W. Granville Ave. Apt 1, Chicago, IL 60659 | 2020-11-03 |
| 1932724200 | Tatyana Menaker | Nurse Practitioner | 2958 West Devon Ave, Chicago, IL 60659 | 2020-06-12 |
| 1508410069 | Kara Lyn Anderson | Counselor | 2551 W. Peterson Ave, Chicago, IL 60659 | 2019-08-01 |
| 1568980019 | Saba Suleman | Counselor | 5815 N Spaulding Ave Apt 3a, Chicago, IL 60659 | 2017-09-05 |
| 1639695257 | Go Diagnostics Inc | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 5862 N Lincoln Ave, Suite 4, Chicago, IL 60659 | 2017-08-15 |
| 1972039568 | Trilogy, Inc. | Community/Behavioral Health | 2551 W Peterson Ave, Chicago, IL 60659 | 2017-05-03 |
| 1689029050 | Soulu | Voluntary or Charitable | 3557 W Peterson Ave #122, Chicago, IL 60659 | 2016-05-04 |
| 1730540550 | Michael Wei-tsi Chien | Dentist | 3425 W Peterson Ave Ste 107, Chicago, IL 60659 | 2016-03-08 |
| 1497129688 | Acquaint Homecare LLC | Home Health | 3525 West Peterson Avenue, Unit 118, Chicago, IL 60659 | 2015-11-25 |
| 1083054621 | Rebecca Schnell | Speech-Language Pathologist | 6124 N Saint Louis Ave, Chicago, IL 60659 | 2013-06-27 |
| Find all providers in zip 60659 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790392587 | Adriana Casillas | Optometrist | 11129 S Avenue J, Chicago, IL 60617-6910 | 2020-09-25 |
| 1538778097 | Opt Vision | Optometrist | 5371 W Lawrence Ave Ste A, Chicago, IL 60630-3695 | 2020-07-30 |
| 1578180147 | Ortizii PC | Optometrist | 111 N Wabash Ave Ste 1111, Chicago, IL 60602-3119 | 2020-06-30 |
| 1588280358 | Iwona B. Lazarz | Optometrist | 6500 W Irving Park Rd Ste I, Chicago, IL 60634-2454 | 2020-06-17 |
| 1134741622 | Cvs Aoc Services, L.L.C. | Optometrist | 4051 North Lincoln, Store 8751, Chicago, IL 60618 | 2020-05-07 |
| 1154941367 | Sun Myung Park | Optometrist | 465 N Park Dr Apt 2203, Chicago, IL 60611-0008 | 2020-04-17 |
| 1578196341 | Steven K. Siu | Optometrist | 2719 S Princeton Ave Fl 1, Chicago, IL 60616-4883 | 2020-02-19 |
| 1235789884 | Courtney Bandemer | Optometrist | 3708 N Southport Ave, Chicago, IL 60613-6888 | 2019-09-16 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1154977759 | Keralyn Totten | Optometrist | 230 E Ohio St Ste 120, Chicago, IL 60611-3266 | 2019-08-11 |
| Find all providers in CHICAGO | ||||
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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.