Provider Demographics
NPI:1821740952
Name:KLINGBEIL, JORDYN VIRGINIA
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:VIRGINIA
Last Name:KLINGBEIL
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 1:12911 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-5018
Mailing Address - Country:US
Mailing Address - Phone:630-788-6520
Mailing Address - Fax:
Practice Address - Street 1:210 N HAMMES AVE STE 204
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-8139
Practice Address - Country:US
Practice Address - Phone:815-722-4384
Practice Address - Fax:815-722-4390
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist