Individual
JORDAN RICHARD KNUDSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4419 W NORTH AVE, MELROSE PARK, IL 60160-1021
(773) 205-4558
Mailing address
4419 W NORTH AVE, MELROSE PARK, IL 60160-1021
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/09/2025
Last updated
04/09/2025
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