Provider Demographics
NPI:1225697113
Name:PERLMAN, JORDAN S (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:S
Last Name:PERLMAN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 N SHERIDAN RD APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-5220
Mailing Address - Country:US
Mailing Address - Phone:847-609-3393
Mailing Address - Fax:
Practice Address - Street 1:6232 N PULASKI RD STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5133
Practice Address - Country:US
Practice Address - Phone:847-609-3393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-13
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional