MEDICARE: JESSICA ARDEN M.D., PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0001X	Radiation Oncology Physician	4301505271	MI

General Provider Information

NPI Number	:	1235588344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA ARDEN M.D., PHD

Provider Business Mailing Address
First Line	:	PO BOX 84868
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60689-4868
Country	:	US
Telephone Number	:	231-935-7100
Fax Number	:

Provider Business Practice Location Address
First Line	:	217 S MADISON ST
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-2321
Country	:	US
Telephone Number	:	231-392-8400
Fax Number	:	231-392-8467

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	05/12/2026

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