MEDICARE: DR. PATRICK J GORDON MD

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	208M00000X	Hospitalist Physician	036159154	IL
2	208M00000X	Hospitalist Physician	36781	IA
3	207Q00000X	Family Medicine Physician	36781	IA
4	207Q00000X	Family Medicine Physician	036159154	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036159154	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1538181375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK J GORDON MD

Provider Business Mailing Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-933-4700
Fax Number	:	630-933-4427

Provider Business Practice Location Address
First Line	:	25 N WINFIELD RD
Second Line	:
City	:	WINFIELD
State	:	IL
Zip	:	60190-1379
Country	:	US
Telephone Number	:	630-933-4700
Fax Number	:	630-933-4427

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	04/06/2026

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