Individual
JESSICA NIKLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-7900
Mailing address
620 IROQUOIS AVE, NAPERVILLE, IL 60563-1339
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007267
IL
Other
Enumeration date
10/04/2023
Last updated
10/04/2023
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