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General NPI Number Information
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NPI Number | 1972361657
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Entity Type | Individual
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Provider Name | JACLYN MARIE WERLE PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 3140 FINLEY RD STE 400D
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-1376
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Country | US
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Telephone | 331-775-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 869 BENEDETTI DR APT 107
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City | NAPERVILLE
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State | IL
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Zip | 60563-8935
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Country | US
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Telephone | 630-251-8558
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070027030
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License Number State | IL
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