=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831867332
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JORDYN RENEE POPE
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/31/2021
-----------------------------------------------------
Last Update Date | 12/26/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 929 W BELMONT AVE
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60657-4408
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 773-496-4433
-----------------------------------------------------
Fax | 773-496-4430
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3420 N LAKE SHORE DR APT 8K
-----------------------------------------------------
City | CHICAGO
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60657-9416
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-795-2606
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 178021978
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------