Physician Compare National (NPI:1003257254)

HEALTHCARE PROVIDER: JORDAN MARK KLUEWER D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003257254
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1951539824
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140123000060
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KLUEWER
	Individual professional last name
Provider First Name	JORDAN
	Individual professional first name
Provider Middle Name	MARK
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NORTHWESTERN COLLEGE OF CHIROPRACTIC
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	CHIROPRACTIC
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1229 N CTR ST
	Group Practice or individual's line 1 address
City	BEAVER DAM
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	539161147
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M