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:
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Health care specialties

SpecialtyCodeLicense #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 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295857845 NPPES
Illinois Other CJ05640701P EI CREDENTIAL NUMBER

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