DR. MARK JORDAN (NPI# 1740374461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740374461 |
| Entity Type | Individual |
| Full Name | DR. MARK JORDAN |
| Credential | PSY.D. |
| Practice Address |
2701 W 68th Street Chicago IL 60629 |
| Mailing Address |
162 S Normandy Chicago Heights IL 60411 |
| Practice Telephone | 7089919002 |
| Practice Fax Number | 9089919003 |
| Mailing Telephone | 6302184369 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
71005770 | IL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BC/BS ILLINOIS | BLUE CROSS BLUE SHIE | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760938310 | Mark Jordan | Pharmacist | 5719 Us 23, Oscoda, MI 48750 | 2016-09-01 |
| 1326459892 | Mark Jordan | Case Manager/Care Coordinator | 300 Hartford Dr, Lancaster, OH 43130-1571 | 2014-05-18 |
| 1568801025 | Mark Allen Jordan | Orthopaedic Surgery | 9600 Gross Point Rd Ste 2900, Skokie, IL 60076-1214 | 2013-06-18 |
| 1881772309 | Mark Vernon Jordan | Internal Medicine | 12801 W Wyndridge Ct Apt 203, New Berlin, WI 53151-8799 | 2006-11-01 |
| 1013478338 | Mark Austin Jordan | Behavior Technician | 29174 Sw Town Center Loop W Ste 101, Wilsonville, OR 97070-9309 | 2019-03-28 |
| 1619212966 | Mark Franklin Jordan | Dentist | 6120 Paseo Del Norte, K1, Carlsbad, CA 92011-1150 | 2012-11-27 |
| 1063748085 | Mark Jordan | Pharmacist | 2400 S Avenue A, Yrmc Pharmacy Department, Yuma, AZ 85364-7127 | 2009-10-27 |
| 1902901937 | Mark Saunders Jordan | Specialist | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-09-14 |
| 1831121607 | Mark Louis Jordan | Urology | 90 Bergen St, Doc 2300, Newark, NJ 07103-2425 | 2006-07-06 |
| 1770521080 | Mark Jordan | Internal Medicine | 2546 Balltown Rd, Suite 300, Schenectady, NY 12309-1079 | 2006-06-02 |
| Street Address |
2701 W 68TH STREET |
| City | CHICAGO |
| State | IL |
| Zip Code | 60629 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336125327 | Wadah Atassi | Internal Medicine | 2701 W 68th Street, Professional Pavilion 4 South, Chicago, IL 60629-1813 | 2005-12-21 |
| 1073829990 | Gautam K Bhanushali | Internal Medicine | 2701 W 68th Street, Professional Pavilion 4 South, Chicago, IL 60629 | 2010-08-30 |
| 1558455170 | Marlene Krupa | Psychologist | 2701 W 68th Street, Chicago, IL 60629 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946392 | T & M Care LLC | In Home Supportive Care | 7230 S Talman, Apt 4, Chicago, IL 60629 | 2020-03-06 |
| 1841847811 | Jacqueline Ann Milton | Technician | 6720 South Keating, Chicago, IL 60629 | 2019-08-23 |
| 1194202085 | Andrea Mosqueda | Counselor | 4217 W 59th St, Chicago, IL 60629 | 2018-07-23 |
| 1316439235 | Saliha Awais | Dentist | 5521 S. Kedzie Ave. Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1356833255 | Irfana Ilyas | Dentist | 2403,5521 S Kedzie Ave, Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1871003715 | Siddhi Vinayak Dental | Clinic/Center | 5521 S Kedzie Ave, Unit 105, Chicago, IL 60629 | 2017-10-05 |
| 1477092328 | Debra Shepard | Social Worker | 2601 W. Marquette Rd., Catholic Charities, Chicago, IL 60629 | 2017-02-13 |
| 1255777108 | Jacquelyn Jones | Developmental Therapist | 3108 West Marquette Road Apartment 1-b, Chicago, IL 60629 | 2013-05-20 |
| 1124368030 | Claudia Ballesteros | Interpreter | 5631 S. Richmond, Chicago, IL 60629 | 2013-03-01 |
| Find all providers in zip 60629 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821699166 | Jennifer Knuepfer, Psyd, Pllc | Psychologist | 4256 N Ravenswood Ave Ste 305, Chicago, IL 60613-1114 | 2020-11-03 |
| 1104426170 | Grace Giedgowd | Psychologist | 1640 W Division St Apt 205, Chicago, IL 60622-3939 | 2020-10-29 |
| 1184223364 | Caroline Elisabeth Fulton | Psychologist | 1739 N Elston Ave, Chicago, IL 60642-1544 | 2020-10-20 |
| 1881293108 | Haley Michelle Sims | Psychologist | 65 E Wacker Pl Ste 300, Chicago, IL 60601-7203 | 2020-10-19 |
| 1285231936 | Qianhui Zhang | Psychologist | 1225 W Morse Ave Apt 403, Chicago, IL 60626-5751 | 2020-10-06 |
| 1316544158 | Nancy Marie Picard | Psychologist | 4885 N Hermitage Ave, Chicago, IL 60640-4104 | 2020-10-05 |
| 1730792151 | Jenny Marie Wamsat | Psychologist | 1921 W Diversey Pkwy Apt 402, Chicago, IL 60614-9412 | 2020-08-25 |
| 1497365910 | Sara Sirota | Psychologist | 5443 N Broadway St # 2s, Chicago, IL 60640-1703 | 2020-08-10 |
| 1053920512 | Alyse Renae Bedell | Psychologist | 5841 S Maryland Ave Ste 300, Chicago, IL 60637-1443 | 2020-07-30 |
| 1699392688 | Hongying Chen | Psychologist | 720 W Sheridan Rd Apt 3s, Chicago, IL 60613-3252 | 2020-06-25 |
| Find all providers in CHICAGO | ||||
Please comment or provide details below to improve the information on DR. MARK JORDAN.
| 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.