Individual provider Active NPI

Kenneth Warren Jordan, SLP

  • Speech-Language Pathologist
  • Glenview, IL
National Provider Identifier
1285278580
Registry record updated Oct 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
146003645 Issued in IL
Practice address
2600 Compass Rd
Glenview, IL 60026-8001
Phone
(847) 441-5593
NPI assigned
Oct 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 146003645 IL Primary

Addresses

Primary practice location

2600 Compass Rd
Glenview, IL 60026-8001

Mailing address

2600 Compass Rd
Glenview, IL 60026-8001

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
146003645ILMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572393600000",
    "number": "1285278580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 COMPASS RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268001",
            "telephone_number": "847-441-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KENNETH",
        "middle_name": "WARREN",
        "name_prefix": "Mr.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146003645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.