KENNETH BERNARD JORDAN (NPI# 1366049900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366049900 |
| Entity Type | Individual |
| Full Name | KENNETH BERNARD JORDAN |
| Credential | MD |
| Practice Address |
2160 S 1st Ave Maywood IL 60153-3328 |
| Practice Telephone | 7082162687 |
| Mailing Telephone | 4146147073 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
125.077263 | IL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801935044 | Kenneth Michael Jordan | Radiologic Technologist | 4201 E Loop 820 S, Ste C, Ft Worth, TX 76119-4443 | 2007-02-05 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1235186438 | Kenneth A Jordan | Internal Medicine | 295 Maple St Ste 202, Tawas City, MI 48763-9352 | 2006-05-31 |
| 1902867252 | Kenneth Wesley Jordan | Chiropractor | 705 North Fraser St, Georgetown, SC 29442-0958 | 2006-03-28 |
| 1477537116 | Kenneth George Jordan | Specialist | 1660 Plum Ln, Redlands, CA 92374-4532 | 2005-12-06 |
| 1285278580 | Kenneth Warren Jordan | Speech-Language Pathologist | 2600 Compass Rd, Glenview, IL 60026-8001 | 2019-10-30 |
| 1548739147 | Kenneth Jordan | Counselor | 1700 Airport Way S, Seattle, WA 98134-1618 | 2018-11-13 |
| 1386122141 | Kenneth Jordan | Social Worker | 29 Maple St, Littleton, NH 03561 | 2018-08-03 |
| 1932440385 | Kenneth W Jordan | Pharmacist | 701 E Milam St, Mexia, TX 76667-2445 | 2013-03-11 |
| 1184628505 | Kenneth Wayne Jordan | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2005-06-13 |
| Street Address |
2160 S 1ST AVE |
| City | MAYWOOD |
| State | IL |
| Zip Code | 60153-3328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174525489 | Michael Jm Raffin | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2005-06-01 |
| 1124634712 | Abhilasha Nitin Borkar | Pathology | 2160 S 1st Ave, Maywood, IL 60153 | 2020-09-18 |
| 1306450325 | Linda Ippolito | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339135 | Meghan Henry | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-09-08 |
| 1194339911 | Victoria Leah Drozd | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-31 |
| 1396357588 | Madison Schaefer | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1134731375 | Otanthia S Williams-brady | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-08-19 |
| 1205454287 | Janet Nickels | Audiologist | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-07-07 |
| 1417574054 | Kathryn Clemans | Nurse Anesthetist, Certified Registered | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-30 |
| 1992320592 | Jeslyn John | Nurse Practitioner | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053933077 | Judie Noemie Hoilat | Internal Medicine | 2160 S 1st Avenue, Maywood, IL 60153 | 2020-05-13 |
| 1457972457 | Yuchen Zheng | Student in an Organized Health Care Education/Training Program | Department of Neurology, Loyola University Medical Cent, 2160 S. First Ave, Maywood, IL 60153 | 2020-04-30 |
| 1437779519 | Amna Amad Siddiqui | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue, Loyola University Medical Center, Maywood, IL 60153 | 2020-04-20 |
| 1982232211 | Brian Kurtz | Student in an Organized Health Care Education/Training Program | 2160 S First Ave, Bulding 105-suite 2840a, Maywood, IL 60153 | 2020-03-31 |
| 1902434947 | Saadiya Jabbar | Psychiatry & Neurology | Loyola University Medical Center, Building 105, Suite 1940, Maywood, IL 60153 | 2020-03-27 |
| 1558919472 | Linda Sue Moton | Technician | 10 South 15 Apt. 1, Maywood, IL 60153 | 2019-09-04 |
| 1760047518 | Braden Robert Dasovic | Student in an Organized Health Care Education/Training Program | 2160 S. First Avenue Building 105/room 2700, Department, Loyola Medical Center, Maywood, IL 60153 | 2019-05-07 |
| 1134680713 | Madeline Shaoyun Tiee | Orthopaedic Surgery | Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153 | 2019-03-27 |
| 1538629746 | Michael Murphy | Orthopaedic Surgery | 2160 S 1st Ave., Maguire Center, Dept of Ortho Surg, Maywood, IL 60153 | 2019-03-22 |
| 1053871681 | Michael V Padua | Psychiatry & Neurology | 2160 S 1st Ave Bldg, Maywood, IL 60153 | 2019-03-20 |
| Find all providers in zip 60153 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346462124 | Lei Xu | Psychiatry & Neurology | 2160 South Frist Avenue, Maguire Center Building 105 Room 2700, Maywood, IL 60153 | 2007-05-02 |
| 1073141792 | Adam Wadina | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-29 |
| 1144857327 | Alexandra Balabanov | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-03-26 |
| 1376003814 | Zachary Dierk Pardieck | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2019-03-21 |
| 1467957779 | Diana Nathalie Andino | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153 | 2018-03-28 |
| 1053816843 | Carlos Lara | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153 | 2018-03-26 |
| 1790280675 | Jasmine Singh | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153 | 2018-03-24 |
| 1013448901 | Erin Rebecca Fiedler | Psychiatry & Neurology | 2160 S First Ave, Loyola University Medical Gme Office 105/2840, Maywood, IL 60153 | 2017-03-23 |
| 1831552926 | Adam Schnitz | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-04-05 |
| 1134582729 | William Taylor | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2016-03-31 |
| Find all providers in MAYWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.