Provider Demographics
NPI:1225575053
Name:DUNCAN, JORRI LYNN (MS)
Entity Type:Individual
Prefix:
First Name:JORRI
Middle Name:LYNN
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JORRI
Other - Middle Name:LYNN
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS
Mailing Address - Street 1:670 MACKINAW AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-4012
Mailing Address - Country:US
Mailing Address - Phone:773-956-3478
Mailing Address - Fax:
Practice Address - Street 1:670 MACKINAW AVE
Practice Address - Street 2:
Practice Address - City:CALUMET CITY
Practice Address - State:IL
Practice Address - Zip Code:60409-4012
Practice Address - Country:US
Practice Address - Phone:773-956-3478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14039447235Z00000X
TX111645235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist