Provider Demographics
NPI:1194834309
Name:ORDMAN, ARNOLD MICHAEL (PHD)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:MICHAEL
Last Name:ORDMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 W FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3023
Mailing Address - Country:US
Mailing Address - Phone:773-549-7813
Mailing Address - Fax:
Practice Address - Street 1:1755 W FLETCHER ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-3023
Practice Address - Country:US
Practice Address - Phone:773-612-1895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071-003381103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL016-73143OtherBLUE CROSS BLUE SHIELD
IL280609OtherVALUE OPTIONS
IL019-25-7000OtherMAGELLAN BEHAVIORAL HEALT
IL460-3568OtherAETNA