Individual
DANNIELLE D JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6435 MAIN ST STE 110, WOODRIDGE, IL 60517-1296
(630) 964-5406
(630) 964-5411
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-015970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00886036
MEDICARE RAILROAD
IL
Enumeration date
07/23/2007
Last updated
12/31/2019
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