SearchIllinois163W00000X

Kelly Jordan-Licht

NPI 1114422573 · on the registry since 2018

Practice

Address
811 W John St # 126
Yorkville, IL 60560
Phone
(630) 553-8048
Fax
(630) 553-9604

Registry record

Primary taxonomy
163W00000X
163W00000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2018-03-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois