Individual
JORDAN ROSENBLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 834-4064
Mailing address
5841 S MARYLAND AVE # MC1099, CHICAGO, IL 60637-1447
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036076269
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076269
—
IL
Enumeration date
01/16/2007
Last updated
11/11/2021
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