MEDICARE: JORDAN MARIE SPECHT

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	106H00000X	Marriage & Family Therapist		IL

General Provider Information

NPI Number	:	1013796721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN MARIE SPECHT

Provider Business Mailing Address
First Line	:	3907 N DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3969
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 N DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3969
Country	:	US
Telephone Number	:	773-423-8447
Fax Number	:

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

Provider Enumeration Date	:	09/22/2023
Last Update Date	:	12/31/2025

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Directions to “ JORDAN MARIE SPECHT ” Practice Location

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