Marnie Reynolds-Jensen, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070006188 Issued in IL

Practice address

9645 Lincolnway LN
Suite 116
Frankfort, IL 60423-1866

Phone

(815) 464-0101

Fax

(815) 464-9191

NPI assigned

Oct 1, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1790112092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10402 SUTTON DALE LN",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604232232",
            "telephone_number": "630-878-3452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9645 LINCOLNWAY LN",
            "address_2": "SUITE 116",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231866",
            "telephone_number": "815-464-0101",
            "fax_number": "815-464-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS-JENSEN",
        "first_name": "MARNIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070006188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS PHYSICAL THERAPIST LICENSE",
            "identifier": "070006188",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Frankfort, IL
• Providers in Frankfort, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.