Individual
WILLIAM JORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 596-5518
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 596-5518
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036112051
IL
2080N0001X
Neonatal-Perinatal Medicine Physician
036112051
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036112051
—
IL
Enumeration date
01/11/2007
Last updated
07/18/2024
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