Provider Demographics
NPI:1992900161
Name:JORDAN, CHRISTIE HWANG (LAC, DIPLAC,MSOM)
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:HWANG
Last Name:JORDAN
Suffix:
Gender:F
Credentials:LAC, DIPLAC,MSOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 N DEARBORN ST STE 800
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-3874
Mailing Address - Country:US
Mailing Address - Phone:312-335-9330
Mailing Address - Fax:
Practice Address - Street 1:650 N DEARBORN ST STE 800
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-3874
Practice Address - Country:US
Practice Address - Phone:312-335-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist