Active NPI
Ann Westcot Jordan, PH.D.
- Psychologist
- Shorewood, IL
National Provider Identifier
1013462829
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 071007284
- Practice address
- 21037 Benjamin Dr
Shorewood, IL 60404-0612 - Phone
- (815) 741-9631
- NPI assigned
- Aug 22, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 071007284 | IL | |
| Psychologist | 103T00000X | 071007284 | IL | Primary |
Addresses
Primary practice location
21037 Benjamin Dr
Shorewood, IL 60404-0612
Mailing address
21037 Benjamin Dr
Shorewood, IL 60404-0612
Phone (815) 741-9631
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071007284 | IL | MD | Clinical Neuropsychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1013462829",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21037 BENJAMIN DR",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604040612",
"telephone_number": "815-741-9631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21037 BENJAMIN DR",
"city": "SHOREWOOD",
"state": "IL",
"postal_code": "604040612",
"telephone_number": "815-741-9631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ANN",
"middle_name": "WESTCOT",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-08-22",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "103G00000X",
"taxonomy_group": "",
"desc": "Clinical Neuropsychologist",
"state": "IL",
"license": "071007284",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "IL",
"license": "071007284",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shorewood, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.