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Contact Information

JORDAN R YAKICH
12800 N LAKE SHORE DR
MEQUON, WI53097-2418
 Phone: 262-853-6947
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Emergency Care

2279E0002X
Indicates primary specialty

NPI Profile & details for JORDAN R YAKICH · (Male)

NPI Number 1598351173
Status Active
Credentials
Entity Individual
Enumeration date 12/17/2020
Last updated 12/17/2020 - About 5 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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