Individual
TESALIA R JORDENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1550 HOBBS DR, DELAVAN, WI 53115-2027
(262) 740-4200
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
125.067595
IL
207Q00000X
Family Medicine Physician
Primary
68755
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100079046
—
WI
Enumeration date
06/18/2015
Last updated
07/11/2024
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