| Ben Gordon Center | |
|
12 Health Services Drive Dekalb IL 60115 | |
| (815) 756-4875 | |
| (815) 756-2944 |
| Full Name | Ben Gordon Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12 Health Services Drive, Dekalb, Illinois |
| Authorized Official Name and Position | Michael D Flora (PRESIDENT CEO) |
| Authorized Official Contact | 8157564875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ben Gordon Center 12 Health Services Drive Dekalb IL 60115 Ph: (815) 756-4875 | Ben Gordon Center 12 Health Services Drive Dekalb IL 60115 Ph: (815) 756-4875 |
| NPI Number | 1750327003 |
|---|---|
| Provider Enumeration Date | 06/22/2006 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750327003 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | A0254001A (Illinois) | Primary |
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