MEDICARE: ELENA JORRIN

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	171R00000X	Interpreter

General Provider Information

NPI Number	:	1982150496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA JORRIN

Provider Business Mailing Address
First Line	:	2619 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3007
Country	:	US
Telephone Number	:	773-486-3050
Fax Number	:	773-486-3050

Provider Business Practice Location Address
First Line	:	2619 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60647-3007
Country	:	US
Telephone Number	:	773-486-3050
Fax Number	:	773-486-3050

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

Provider Enumeration Date	:	08/26/2016
Last Update Date	:	08/26/2016

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