Individual
IVY T. JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9310 KENTON AVE, SKOKIE, IL 60076-1336
(847) 676-9010
Mailing address
9310 KENTON AVE, SKOKIE, IL 60076-1336
(312) 405-3126
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1904908
IL
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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