Provider Demographics
NPI:1225755333
Name:PARNELL, JORDAN RAE (CNM)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:RAE
Last Name:PARNELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 STRATFORD RD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-2822
Mailing Address - Country:US
Mailing Address - Phone:847-322-2660
Mailing Address - Fax:
Practice Address - Street 1:328 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:WILMETTE
Practice Address - State:IL
Practice Address - Zip Code:60091-2895
Practice Address - Country:US
Practice Address - Phone:847-475-1224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife