MEDICARE: KATHERINE JELINEK 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
1	225100000X	Physical Therapist	070025468	IL

General Provider Information

NPI Number	:	1962004283
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE JELINEK DPT

Provider Business Mailing Address
First Line	:	750 N RUSH ST APT 901
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2561
Country	:	US
Telephone Number	:	630-485-8845
Fax Number	:

Provider Business Practice Location Address
First Line	:	1346 W GEORGE ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-6624
Country	:	US
Telephone Number	:	312-650-5522
Fax Number	:

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

Provider Enumeration Date	:	11/11/2020
Last Update Date	:	12/12/2023

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Directions to “ KATHERINE JELINEK DPT” Practice Location

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