MEDICARE: DR. JEFFREY GLEN GORDON D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	019023383	IL

General Provider Information

NPI Number	:	1932371259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY GLEN GORDON D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 29052
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-0052
Country	:	US
Telephone Number	:	773-445-3337
Fax Number	:	773-445-3340

Provider Business Practice Location Address
First Line	:	8244 S KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60652-3329
Country	:	US
Telephone Number	:	773-445-3337
Fax Number	:	773-445-3340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2008
Last Update Date	:	02/18/2022

Similar Medicare Providers

1225210495 — FAITH HOME HEALTH CARE, INC.
Practice Location Address:

8224 S KEDZIE AVE FL 2
CHICAGO, IL
60652-3329

Practice Phone: 708-681-2853
Practice Fax: 708-666-8887

1447410139 — THE PREVENTIVE DENTISTRY CNTR PC
Practice Location Address:

8244 S KEDZIE AVE
CHICAGO, IL
60652-3329

Practice Phone: 773-445-3337
Practice Fax: 773-445-3340

1881843290 — AMERICAN UNITED PHYSICAL THERAPY P.C.
Practice Location Address:

8224 S KEDZIE AVE
CHICAGO, IL
60652-3329

Practice Phone: 773-721-5656
Practice Fax: 773-721-5757

1699566430 — DEBORAH ANN DOZIER REGISTERED NURSE
Practice Location Address:

8224 S KEDZIE AVE FL 2
CHICAGO, IL
60652-3329

Practice Phone: 708-681-2853
Practice Fax: 708-666-8887

1184417719 — BRENDA K WHITESIDE
Practice Location Address:

8224 S KEDZIE AVE
CHICAGO, IL
60652-3329

Practice Phone: 708-681-2853
Practice Fax:

1265328496 — CASSANDRA BUTLER REGISTERED NURSE
Practice Location Address:

8224 S KEDZIE AVE STE 2
CHICAGO, IL
60652-3329

Practice Phone: 708-681-2853
Practice Fax:

Directions to “ DR. JEFFREY GLEN GORDON D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.