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NPI Code Detail

MEDICARE: MONICA R JORDAN

MEDICARE: MONICA R JORDAN
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
1101YM0800XMental Health Counselor180.007998IL

General Provider Information

NPI Number : 1417255696
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA R JORDAN
Provider Business Mailing Address
First Line : 16050 S CLEARWATER DR
Second Line :
City : PLAINFIELD
State : IL
Zip : 60586-1041
Country : US
Telephone Number : 708-351-9050
Fax Number :
Provider Business Practice Location Address
First Line : 225 N MICHIGAN AVE STE 1430
Second Line :
City : CHICAGO
State : IL
Zip : 60601-7653
Country : US
Telephone Number : 312-766-6780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2011
Last Update Date : 02/10/2025

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Directions to “ MONICA R JORDAN ” Practice Location

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