Individual
KELLY MARIE JORDAN-LICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
811 W JOHN ST # 126, YORKVILLE, IL 60560-9249
(630) 553-8048
(630) 553-9604
Mailing address
811 W JOHN ST # 126, YORKVILLE, IL 60560-9249
(630) 553-8048
(630) 553-9604
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041317669
IL
Other
Enumeration date
03/28/2018
Last updated
03/28/2018
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