Provider Demographics
NPI:1699475756
Name:WOJCZYNSKI, JOURDAN M
Entity type:Individual
Prefix:
First Name:JOURDAN
Middle Name:M
Last Name:WOJCZYNSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2834 N ORCHARD ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-9801
Mailing Address - Country:US
Mailing Address - Phone:205-422-1756
Mailing Address - Fax:
Practice Address - Street 1:2834 N ORCHARD ST APT 3
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-9801
Practice Address - Country:US
Practice Address - Phone:205-422-1756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-07
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist