NPI 1013460781

Jessica Jacknow

Practitioner Physical Therapy Assistant Forest Park, IL

Practice location

Address: 140 Lathrop Ave, Forest Park, IL 60130-1067
Phone: (773) 209-5377

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160003547 (IL)

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Registry record

NPI: 1013460781
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Jul 2016
Record last updated: 29 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.