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General NPI Number Information
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NPI Number | 1295676492
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Entity Type | Individual
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Provider Name | JESSICA BRITTANY LUNA PTA
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Gender | Female
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Dates
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Enumeration Date | 04/02/2026
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Last Update Date | 04/02/2026
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Provider Practice Location Address
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Address Line | 2323 MCDANIEL AVE
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City | EVANSTON
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State | IL
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Zip | 60201-2549
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Country | US
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Telephone | 877-525-5832
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Fax |
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Provider Business Mailing Address
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Address Line | 2636 N 72ND CT
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City | ELMWOOD PARK
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State | IL
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Zip | 60707-1650
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Country | US
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Telephone | 773-668-4042
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 160010392
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License Number State | IL
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