Individual
JORDAN ELMOWITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1900 W. POLK STREET, CLINIC D, CHICAGO, IL 60612
(866) 600-2273
Mailing address
1900 W POLK STREET, CLINIC D, CHICAGO, IL 60612
(917) 797-4559
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
019032670
IL
Other
Enumeration date
04/08/2020
Last updated
09/06/2022
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