Individual
WYETH JESS JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(312) 609-0300
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
036134726
IL
Other
Enumeration date
03/31/2011
Last updated
12/07/2014
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