Individual
JORDAN B PRITIKIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 W WASHINGTON ST, SUITE 903, CHICAGO, IL 60602-2703
(312) 372-9355
(312) 372-9356
Mailing address
PO BOX 160, MATTESON, IL 60443-0160
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
036087346
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087346
—
IL
01
—
040017908
RRMC
IL
Enumeration date
08/15/2005
Last updated
09/14/2023
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