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NPI Code Detail

MEDICARE: JAEL JORDANO QUINTANA

MEDICARE:   JAEL JORDANO QUINTANA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1952250854
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAEL JORDANO QUINTANA
Provider Business Mailing Address
First Line : 707 LAKE COOK RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-5613
Country : US
Telephone Number : 877-486-4140
Fax Number :
Provider Business Practice Location Address
First Line : 707 LAKE COOK RD
Second Line :
City : DEERFIELD
State : IL
Zip : 60015-5613
Country : US
Telephone Number : 877-486-4140
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ JAEL JORDANO QUINTANA ” Practice Location

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