Jean Chenoweth, P.T.A.
Individual provider Active NPI Physical Therapy Assistant · Blue Island, IL
NPI 1992810725 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992810725
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 13114 Western Ave
Blue Island, IL 60406-2439 - Phone
- (708) 824-0515
- Fax
- (708) 824-0517
- NPI assigned
- Aug 20, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160-001474 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | IL | Yes |
Addresses
Primary practice location
13114 Western Ave
Blue Island, IL 60406-2439
Mailing address
1816 170TH St
Hazel Crest, IL 60429-1451
Phone (708) 335-1415
Other providers in Blue Island, IL
- Alfredo Cervantes
- Kanti Chaudhari
- Jaime Chavez
- Shilpa Cheela
- Bai Fan Chen
- Belinda Childs
- Lee R Christensen
- Michelle Elizabeth Churchey-Mims
- Aubrey Lynn Ciesiun
- City of Blue Island
All providers in Blue Island, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.