Individual
JESSICA JACKNOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 LATHROP AVE, FOREST PARK, IL 60130-1067
(773) 209-5377
Mailing address
140 LATHROP AVE, FOREST PARK, IL 60130-1067
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003547
IL
Other
Enumeration date
07/29/2016
Last updated
07/29/2016
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