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Individual

JELAINE MARIA JAMES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHS, PT

Contact information

Practice address
5949 W RAYMOND ST, INDIANAPOLIS, IN 46241-4348
(317) 390-5575
(317) 486-2189
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008636A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000362432
ANTHEM IK
IN
05
200519090
IN
Enumeration date
04/14/2006
Last updated
01/11/2012
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