Healthcare Provider Details

I. General information

NPI: 1649193822
Provider Name (Legal Business Name): JENNA WOZNIAK PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 W 103RD ST
CHICAGO IL
60655-1007
US

IV. Provider business mailing address

10314 S HOYNE AVE
CHICAGO IL
60643-2417
US

V. Phone/Fax

Practice location:
  • Phone: 708-422-0990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number070.029092
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: