| Ben Gordon Center | |
|
100 S Latham St Suite 204 Sandwich IL 60548-2276 | |
| (815) 786-7544 | |
| (815) 786-7580 |
| Full Name | Ben Gordon Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 100 S Latham St, Sandwich, Illinois |
| Authorized Official Name and Position | Michael Flora (CEO/PRESIDENT) |
| Authorized Official Contact | 8157564875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ben Gordon Center 100 S Latham St Suite 204 Sandwich IL 60548-2276 Ph: (815) 786-7544 | Ben Gordon Center 100 S Latham St Suite 204 Sandwich IL 60548-2276 Ph: (815) 786-7544 |
| NPI Number | 1598940546 |
|---|---|
| Provider Enumeration Date | 01/08/2008 |
| Last Update Date | 10/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598940546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | A0254001A (Illinois) | Primary |
Northwestern Medicine Ben Gordon Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 S Latham St Ste 204, Sandwich, IL 60548 Phone: 815-786-7544 | |
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