Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jordan James Koczenasz, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1003675315

Jordan James Koczenasz, MD is a Student in an Organized Health Care Education/Training Program in Maywood, Illinois. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2024
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (888) 584-7888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 125.084750 (IL)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1003675315
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 18, 2024
Last updated in NPPESJuly 9, 2024
Certification dateJuly 9, 2024

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