| Doctor Name: | LAUREN JORDAN |
| NPI Number: | 1003254590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OD |
| License Number: | 046010664 |
| Business Practice Address: | 1603 N Alpine Rd Suite 121 Rockford, IL - 611071439 |
| Business Phone Number: | 8153975959 |
| Business Fax Number: | |
| Mailing Address: | 1603 N Alpine Rd, Suite 121 ROCKFORD |
| State: | IL |
| Postal Code: | 611071439 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/06/2013 |
| NPI Last Update Date: | 06/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WP0200X |
| License Number: | 046010664 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | Optometrists who work in Pediatrics are concerned with the prevention, development, diagnosis, and treatment of visual problems in children. |