Jenissa Boneta

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

820 E Terra Cotta Ave Ste 244
Crystal Lake, IL 60014-3655

Phone

(815) 354-8200

NPI assigned

Oct 28, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1659249886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 DURANGO CT",
            "city": "GILBERTS",
            "state": "IL",
            "postal_code": "601364087",
            "telephone_number": "847-802-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 E TERRA COTTA AVE STE 244",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143655",
            "telephone_number": "815-354-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONETA",
        "first_name": "JENISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-28",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodyshop Professional Massage Therapy
• Kimberly A Boersma
• Lisa Bohn, LCSW
• David W Bojan, D.D.S.
• Otilia Boncu, APN, NP-C
• Angela D Bonneville
• Niccolo Anthony Bonomo
• Kavita C. Bosamiya
• Kelsey Botterman, D.C., N.D.
• Alexendra Botzoc, RBT

• Physical Therapy Assistant in Crystal Lake, IL
• Providers in Crystal Lake, IL by specialty
• Physical Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.