Individual provider · Type 1 NPI
Shina Keaonis Gordon, FNP
Psychiatric/Mental Health Nurse Practitioner · Downers Grove, IL
NPI number
1295197697
Active
Practice location
3743 Highland Ave # 2001
Downers Grove, IL 60515-1594
Fax (630) 719-1263
Mailing address
29373 Network Pl
Chicago, IL 60673-1293
Other practice locations
- 4101 1st Ave, Lyons, IL 60534-1028 · (800) 323-8622
- 1341 Warren Ave, Downers Grove, IL 60515-3437 · (630) 719-5454
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 209013602 (IL) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 277-002521 (IL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1295197697
Shina Keaonis Gordon, FNP's National Provider Identifier is 1295197697, issued on Mar 24, 2016. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Downers Grove, IL. The record was last updated on Dec 12, 2024.