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DOMONIQUE GORDON
NPI 1780529123
Student in an Organized Health Care Education/Training Program in Milwaukee, WI

Active since April 22, 2026
2301 N LAKE DR, MILWAUKEE, WI 53211(414) 585-1000 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Domonique Gordon NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOMONIQUE GORDON (NPI 1780529123) is an individual student in an organized health care education/training program in Milwaukee, Wisconsin and active in the NPI registry since April 2026.

NPPES Registry Identity

NPI1780529123
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDOMONIQUE GORDON
Location Address2301 N LAKE DRMilwaukee, WI 53211-4508
Mailing Address2301 N Lake DrMilwaukee, WI 53211-4508
Phone(414) 585-1000
Sole ProprietorNo
Enumeration DateApril 22, 2026
NPPES CertifiedApril 22, 2026
✔ NPI 1780529123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2301 N LAKE DR, Milwaukee, WI 53211
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA MARIE HERZBERG RD
Dietitian, Registered
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 291-1316
MALCOLM CHICOZE IROEGBU
Student in an Organized Health Care Education/Training Program
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-1000
MS. HAEMI LEE M.D.
Student in an Organized Health Care Education/Training Program
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (559) 890-9742
ANN FREIGANG CTRS
Recreation Therapist
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-6750
EMILY CHUNG AGACNP-BC, APNP
Nurse Practitioner (Acute Care)
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 525-1220
MRS. ERICKA RUCK CTRS, CBIS
Recreation Therapist
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-6750
MS. JOAN CAROL BODNAR PTA
Physical Therapy Assistant
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 298-6730
IHC-OBSERVATION CARE LLC
Emergency Medicine
2301 N LAKE DR
MILWAUKEE, WI 53211
Milwaukee County (414) 585-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Domonique Gordon's NPI number?

The NPI number for Domonique Gordon is 1780529123. It was assigned to this individual provider in the NPPES registry on April 22, 2026.

Where is Domonique Gordon located?

Domonique Gordon practices at 2301 N Lake Dr, Milwaukee, WI 53211. The listed phone number is (414) 585-1000.

What is Domonique Gordon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Domonique Gordon was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.