BEN GORDON CENTER (NPI# 1962687913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962687913 |
| Entity Type | Organization |
| Organization Name | BEN GORDON CENTER |
| Practice Address |
599 Pearson Dr Genoa IL 60135-1355 |
| Practice Telephone | 8157846029 |
| Mailing Telephone | 8157846029 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2008-10-08 |
| Authorized Official Name | MICHAEL FLORA (CEO/PRESIDENT) |
| Authorized Official Telephone | 8157564875 |
| Is Organization Subpart | Y |
| Parent Organization Name | BEN GORDON CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
A0254001A | IL | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750327003 | Ben Gordon Center | Clinic/Center | 12 Health Services Drive, Dekalb, IL 60115 | 2006-06-22 |
| 1164802922 | Ben Gordon Center | Preferred Provider Organization | 631 S 1st St, Dekalb, IL 60115-4117 | 2015-06-05 |
| 1164847430 | Ben Gordon Center | Counselor | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2014-02-24 |
| 1457654295 | Ben Gordon Center | Clinic/Center | 21193 Malta Rd, Bldg. A - U154, Malta, IL 60150-9600 | 2010-12-17 |
| 1700037512 | Ben Gordon Center | Clinic/Center | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2008-10-10 |
| 1922277631 | Ben Gordon Center | Community/Behavioral Health | 12 Health Services Dr, Dekalb, IL 60115-9637 | 2008-02-27 |
| 1598940546 | Ben Gordon Center | Clinic/Center | 100 S Latham St, Suite 204, Sandwich, IL 60548-2276 | 2008-01-08 |
| Street Address |
599 PEARSON DR |
| City | GENOA |
| State | IL |
| Zip Code | 60135-1355 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669466801 | Umesh P Goswami | Pediatrics | 599 Pearson Dr, Genoa, IL 60135-1355 | 2005-09-02 |
| 1821327073 | Michael Eugene Andrews | Physical Therapist | 599 Pearson Dr, Genoa, IL 60135-1355 | 2009-12-17 |
| 1013936061 | Karen M Federici | Family Medicine | 599 Pearson Dr, Genoa, IL 60135-1355 | 2006-07-19 |
| 1437176435 | Family First Physicians Sc | Family Medicine | 599 Pearson Dr, Genoa, IL 60135-1355 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821697830 | Mayuri Prashant Shende | Student in an Organized Health Care Education/Training Program | 2160 S. First Ave., Bldg. 105, Suite 2840a, Marywood, IL 60135 | 2020-10-21 |
| 1831368612 | Northern Rehabilitation and Sports Medicine Associates | Physical Therapist | 540 E Main Street, Suite 5, Genoa, IL 60135 | 2008-02-26 |
| 1578582474 | Steven J Disanti | General Practice | 109 South Genoa Street, Genoa Medical Clinic, Genoa, IL 60135 | 2006-07-19 |
| 1558828947 | Victoria Elizabeth Deku | Speech-Language Pathologist | 123 W 1st St, Genoa, IL 60135-1016 | 2019-02-22 |
| 1134321698 | Genoa Kingston Cusd 424 | Local Education Agency (LEA) | 941 W Main St, Genoa, IL 60135-1037 | 2007-06-05 |
| 1992256309 | Angela Moore | Nurse's Aide | 519 W 2nd St, Genoa, IL 60135-1058 | 2016-10-20 |
| 1609887918 | Martha Ann Moegling | Chiropractor | 112 N Emmett St Ste A, Genoa, IL 60135-1087 | 2006-08-11 |
| 1306858154 | Natural Family Health S.c. | Chiropractor | 112 N Emmett St Ste A, Genoa, IL 60135-1087 | 2006-08-12 |
| 1013939602 | Steven J. Disanti D.o. S.c. | Family Medicine | 109 S Genoa St, Genoa, IL 60135-1120 | 2006-07-24 |
| 1659511632 | Sherie Anne Perdue | Dentist | 209 W Main St, Genoa, IL 60135-1145 | 2009-03-03 |
| Find all providers in zip 60135 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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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.