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NPI Code Detail

MEDICARE: JENNIFER MINNIEAR

MEDICARE: JENNIFER MINNIEAR
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 Therapist070006382IL

General Provider Information

NPI Number : 1881304921
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER MINNIEAR
Provider Business Mailing Address
First Line : 1901 SILVER GLEN RD
Second Line :
City : SOUTH ELGIN
State : IL
Zip : 60177-3351
Country : US
Telephone Number : 224-276-2055
Fax Number :
Provider Business Practice Location Address
First Line : 1901 SILVER GLEN RD
Second Line :
City : SOUTH ELGIN
State : IL
Zip : 60177-3351
Country : US
Telephone Number : 224-276-2055
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2022
Last Update Date : 11/30/2022

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Directions to “ JENNIFER MINNIEAR ” Practice Location

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