DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: JENNA MIXON DPT

MEDICARE: JENNA MIXON DPT
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 Therapist14163-24WI

General Provider Information

NPI Number : 1861983777
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNA MIXON DPT
Provider Business Mailing Address
First Line : 12 HARRISON ST
Second Line :
City : OAK PARK
State : IL
Zip : 60304-1771
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5110 W 24TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-2948
Country : US
Telephone Number : 847-364-2435
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2018
Last Update Date : 09/21/2022

Similar Medicare Providers

1225206352 — CICERO DISTRICT 99
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 708-863-4856
Practice Fax:
1083501589 — NANCY CATHERINE IRVINE
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 708-863-4856
Practice Fax:
1528944352 — WENDY TORRES
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 909-561-5673
Practice Fax:
1154207801 — ELIZA GALLERMO
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 708-863-4856
Practice Fax:
1881571545 — KATHLEEN MARY MANGAN
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 708-863-4856
Practice Fax:
1023996659 — JOY JULIE ANNE BUETA MHS CCC-SLP
Practice Location Address:
5110 W 24TH ST
CICERO, IL
60804-2948
Practice Phone: 708-863-4856
Practice Fax:

Directions to “ JENNA MIXON DPT” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.