Individual
JAMIE JENELLE KENTGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3815 E MAIN ST STE B, ST CHARLES, IL 60174-2488
(630) 584-7530
Mailing address
14 RIVERDALE CT, ALGONQUIN, IL 60102-6821
(847) 691-1845
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.014522
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056.014522
STATE LICENSE
IL
Enumeration date
10/12/2021
Last updated
10/14/2021
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