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General NPI Number Information
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NPI Number | 1326938382
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Entity Type | Individual
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Provider Name | JORDAN KING DPT
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Gender | Female
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 150 W HALF DAY RD
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-6591
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Country | US
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Telephone | 773-620-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 3024 COOKSON AVE
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City | ELGIN
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State | IL
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Zip | 60124-8938
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Country | US
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Telephone | 847-749-8094
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 070029260
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License Number State | IL
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