Chingo, Jordan
Chingo, Jordan is an individual health care provider with primary practice located at 1686 Eisenhower Rd , De Pere WI 54115-8145. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Chingo, Jordan can be contacted via phone (920) 496-4700.Contact Information
Primary practice address
1686 Eisenhower Rd
De Pere WI 54115-8145
Phone: (920) 496-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 225XP0200X | 5832-26 | Wisconsin |
Profile Details
| NPI number | 1316305790 |
|---|---|
| LBN Legal business name | Chingo, Jordan |
| Credentials | Registered Occupational Therapist (OTR) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 1st, 2016 |
| Last updated | May 23rd, 2024 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316305790 | NPPES |
| Wisconsin | MEDICAID | 100054065 |
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