Healthcare Provider Details

I. General information

NPI: 1730363557
Provider Name (Legal Business Name): JODY LYNN PLOWMAN L.C.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2007
Last Update Date: 12/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9601 165TH ST SUITE 6
ORLAND PARK IL
60467-5660
US

IV. Provider business mailing address

9601 165TH ST SUITE 6
ORLAND PARK IL
60467-5660
US

V. Phone/Fax

Practice location:
  • Phone: 630-542-1059
  • Fax:
Mailing address:
  • Phone: 630-542-1059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: