Search › Illinois › 207Q00000X
Kenneth Jordan, DO
NPI 1710081708 · on the registry since 2006
Practice
- Address
- 520 West Madison Street
Madison Street Clinic Pc
Pontiac, IL 61764 - Phone
- (815) 844-6106
- Fax
- (815) 842-2526
- Organisation at this address
- Madison Street Clinic P.C.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
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