Healthcare Provider Details

I. General information

NPI: 1942388681
Provider Name (Legal Business Name): CARIN R GORDON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3320 CULVER ST
EVANSTON IL
60201-1114
US

IV. Provider business mailing address

3320 CULVER ST
EVANSTON IL
60201-1114
US

V. Phone/Fax

Practice location:
  • Phone: 518-527-8920
  • Fax: 414-435-9624
Mailing address:
  • Phone: 518-527-8920
  • Fax: 414-435-9624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number70724
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: