Jamelie Kathleen Ford III

Individual provider Active NPI Case Manager/Care Coordinator · Summit, IL

NPI 1487779690 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1487779690
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
7424 Archer Ave
Summit, IL 60501-1279
Phone
(708) 458-8228
Fax
(708) 458-9177
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

7424 Archer Ave
Summit, IL 60501-1279

Mailing address

16 163Rd PL
Calumet City, IL 60409-6002
Phone (708) 933-0724

Other providers in Summit, IL

All providers in Summit, IL · Case Manager/Care Coordinator in Illinois

Sources for this page

Verify at the official NPI Registry.