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General NPI Number Information
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NPI Number | 1386663425
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Entity Type | Individual
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Provider Name | GORDON JAMES KINZLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1200 S YORK RD SUITE 4290
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City | ELMHURST
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State | IL
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Zip | 60126-5626
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Country | US
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Telephone | 630-758-8600
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Fax | 630-758-8603
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Provider Business Mailing Address
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Address Line | 929 NEWTON AVE
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City | GLEN ELLYN
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State | IL
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Zip | 60137-3772
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Country | US
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Telephone | 630-545-9739
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Fax | 630-545-9514
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036-071519
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License Number State | IL
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