Healthcare Provider Details

I. General information

NPI: 1972392561
Provider Name (Legal Business Name): JORDAN KRONES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 W WASHINGTON ST STE 230
EAST PEORIA IL
61611-2560
US

IV. Provider business mailing address

1230 ALLISON LN
SCHAUMBURG IL
60194-2720
US

V. Phone/Fax

Practice location:
  • Phone: 309-694-6462
  • Fax:
Mailing address:
  • Phone: 630-212-7345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: