Provider Demographics
NPI:1366246084
Name:BECK, JORDAN NICOLE
Entity type:Individual
Prefix:MS
First Name:JORDAN
Middle Name:NICOLE
Last Name:BECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-3739
Mailing Address - Country:US
Mailing Address - Phone:224-760-1182
Mailing Address - Fax:
Practice Address - Street 1:29 STONEHILL RD UNIT D
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-9449
Practice Address - Country:US
Practice Address - Phone:224-760-1182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician