Jordan, Carmen Shafe
Jordan, Carmen Shafe is an individual health care provider with primary practice located at 1401 E State St , Rockford IL 61104-2315. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Jordan, Carmen Shafe can be contacted via phone (815) 489-4470.Contact Information
Primary practice address
1401 E State St
Rockford IL 61104-2315
Phone: (815) 489-4470
Fax: (815) 490-5858
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | Illinois |
Profile Details
NPI number | 1295857845 |
---|---|
LBN Legal business name | Jordan, Carmen Shafe |
Credentials | M.A., CCC-SLP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 4th, 2007 |
Last updated | Jul 8th, 2007 - about 18 years 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 | 1295857845 | NPPES |
Illinois | Other | CJ05640701P | EI CREDENTIAL NUMBER |
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