Healthcare Provider Details

I. General information

NPI: 1851214647
Provider Name (Legal Business Name): MSAADA PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15507 S ROUTE 59 STE 107E
PLAINFIELD IL
60544-2723
US

IV. Provider business mailing address

519 LITCHFIELD WAY
OSWEGO IL
60543-4203
US

V. Phone/Fax

Practice location:
  • Phone: 708-773-6957
  • Fax:
Mailing address:
  • Phone: 708-773-6957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: TONNI MINETTE JORDAN
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 708-773-6957