KENNETH N. JORDAN DO – NPI #1710081708
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

KENNETH JORDAN is a physician located in PONTIAC, IL. NPPES has assigned the NPI number 1710081708 to KENNETH JORDAN on September 11, 2006. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 19 years ago on Jul 08, 2007. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for KENNETH JORDAN below.

NPI Profile for
KENNETH N. JORDAN

NPI Number
1710081708
Enumeration Date

(about 20 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
KENNETH N. JORDAN
Credentials
DO
Primary location
520 WEST MADISON STREET
MADISON STREET CLINIC PC
PONTIAC, IL 61764
Phone: (815) 844-6106 Fax: (815) 842-2526
Mailing address
520 WEST MADISON
PONTIAC, IL 61764
Phone: (815) 844-6106 Fax: (815) 842-2526
Sole Proprietor
No
Updated
Identifiers

Identifiers for KENNETH JORDAN

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIL036052185
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
IL 003036052185

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.