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Individual
JESSICA L DIMMER
Active
Individual
JESSICA L DIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016193
IL
225100000X
Physical Therapist
33682
CA
225100000X
Physical Therapist
5501012425
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619908
BCBS IL GROUP
IL
01
—
567700
MEDICARE GROUP NUMBER
IL
01
—
568080
MEDICARE GROUP NUMBER
IL
01
—
568150
MEDICARE GROUP NUMBER
IL
01
—
650E018390
BCBSM
—
Enumeration date
09/11/2006
Last updated
07/24/2024
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