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Individual

WANASINGHE JAYASENA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
211 WAUKEGAN RD, STE 300, NORTHFIELD, IL 60093-2757
(847) 724-7600
Mailing address
211 WAUKEGAN RD, STE 300, NORTHFIELD, IL 60093-2757
(847) 724-7600

Taxonomy

Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
070009093
IL

Other

Enumeration date
01/26/2011
Last updated
01/26/2011
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