Individual
JORDAN NICOLE REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACP, QMHP
Contact information
Practice address
2310 W ROOSEVELT RD, CHICAGO, IL 60608-1131
(312) 602-1467
Mailing address
2225 N HALSTED ST APT 26, CHICAGO, IL 60614-9161
(704) 681-3377
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/06/2020
Last updated
07/14/2021
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