Jennie Marie Gura
Individual provider Active NPI Developmental Therapist · Minooka, IL
NPI 1114286903 · NPPES record last updated May 14, 2012
Key facts
- NPI
- 1114286903
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Developmental Therapist 222Q00000X
- Practice address
- 209 Massasoit St
Minooka, IL 60447-9149 - Phone
- (815) 274-5750
- NPI assigned
- May 14, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | Yes |
Addresses
Primary practice location
209 Massasoit St
Minooka, IL 60447-9149
Mailing address
209 Massasoit St
Minooka, IL 60447-9149
Phone (815) 274-5750
Other providers in Minooka, IL
- John Georgis
- Ellen Goodwin
- Douglas Gossen
- Michael S Greenwald
- Nya Gudeman
- Happy Sounds, Inc.
- Wanda Hardy Perkins
- Home Hearing Helpers Inc
- Michelle L Hoven
- Neha Jhawar Howard
All providers in Minooka, IL · Developmental Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.