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NPI Code Detail

MEDICARE: SUSAN LEONA JONES PT

MEDICARE:   SUSAN LEONA JONES  PT
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
1225100000XPhysical Therapist070.006596IL

General Provider Information

NPI Number : 1427617968
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN LEONA JONES PT
Provider Business Mailing Address
First Line : 5441 N EAST RIVER RD
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1199
Country : US
Telephone Number : 773-507-4163
Fax Number :
Provider Business Practice Location Address
First Line : 5441 N EAST RIVER RD
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1199
Country : US
Telephone Number : 773-507-4163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2019
Last Update Date : 06/09/2019

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Directions to “ SUSAN LEONA JONES PT” Practice Location

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