Individual provider Active NPI

Susan Jordan, NP

  • Adult Health Nurse Practitioner
  • Elk Grove Village, IL
National Provider Identifier
1295018653
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209004863 Issued in IL
Practice address
800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367
Phone
(847) 981-3660
NPI assigned
Sep 22, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209004863 IL Primary

Addresses

Primary practice location

800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367

Mailing address

800 Biesterfield Rd Ste 510
Elk Grove Village, IL 60007-3367
Phone (847) 981-3660

Other names 1

  • Susan Chua-Jordan Wertz Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1316649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1295018653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073367",
            "telephone_number": "847-981-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 BIESTERFIELD RD STE 510",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073367",
            "telephone_number": "847-981-3660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SUSAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-22",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209004863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "WERTZ",
            "middle_name": "CHUA-JORDAN",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Elk Grove Village, IL

Sources for this page

Verify at the official NPI Registry.