MEDICARE: JENNIFER LYNN BOCHENEK P.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	070007667	IL

General Provider Information

NPI Number	:	1164665121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNN BOCHENEK P.T

Provider Business Mailing Address
First Line	:	1216 EAST CENTRAL RODAD
Second Line	:	SUITE 200
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2859
Country	:	US
Telephone Number	:	847-222-0878
Fax Number	:	847-222-1087

Provider Business Practice Location Address
First Line	:	1216 E CENTRAL RD
Second Line	:	SUITE 200
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-2860
Country	:	US
Telephone Number	:	847-222-0878
Fax Number	:	847-222-1087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2009
Last Update Date	:	04/07/2009

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