Jordan B Pritikin
Plastic Surgeon (Head & Neck)
111 W Washington St Suite 903
Chicago
, Illinois 60602-2703
Jordan B Pritikin
Plastic Surgeon (Head & Neck)
111 W Washington St Suite 903
Chicago
, Illinois 60602-2703
(708) 747-9991
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About
Features
Specialties
- Plastic Surgeon (Head & Neck)
Languages spoken
- English
Location
First Address
- Jordan B Pritikin
- Po Box 160
- Matteson, IL
- Zip : 60443-0160
- Fax : (708) 747-9991
- Phone : (708) 747-5850
Second Address
- Jordan B Pritikin
- 111 W Washington St Suite 903
- Chicago, IL
- Zip : 60602-2703
- Fax : (312) 372-9356
- Phone : (312) 372-9355
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Is Jordan B Pritikin a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 036087346 | IL |
National Provider Identifier
| NPI | 1770585259 |
|---|---|
| Provider Name | Jordan B Pritikin |
| First Address | Matteson, IL 60443-0160 |
| Second Address | Chicago, IL 60602-2703 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/08/2005 |
| Last Update Date | 13/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036087346 | (05) | IL |
| 040017908 | RRMC (01) | IL |
| F98613 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.