Individual
MR. JORDAN ALLEN ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
7 HAPP ROAD, NEW TRIER TOWNSHIP HIGH SCHOOL, NORTHFIELD, IL 60093
(847) 784-7750
Mailing address
1318 W BRYN MAWR AVE, APT G, CHICAGO, IL 60660-4237
(815) 670-4187
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003162
IL
Other
Enumeration date
03/06/2012
Last updated
06/13/2014
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