| Doctor Name: | MRS. SUSAN E. JORDAN |
| NPI Number: | 1003913799 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 209004797 |
| Business Practice Address: | 707 N Logan Avenue Danville Polyclinic, Ltd. Danville, IL - 618324360 |
| Business Phone Number: | 2174774720 |
| Business Fax Number: | 2174774758 |
| Mailing Address: | 707 N Logan Avenue, Danville Polyclinic, Ltd. DANVILLE |
| State: | IL |
| Postal Code: | 618324360 |
| Phone Number: | 2174774720 |
| Fax Number: | 2174774758 |
| NPI Enumeration Date: | 09/17/2006 |
| NPI Last Update Date: | 01/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 209004797 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |