Individual
JOLENE NIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-018451
IL
225100000X
Physical Therapist
Primary
17133-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL6237009
MEDICARE
IL
01
—
IL6238009
MEDICARE
IL
01
—
IL6697015
MEDICARE
IL
01
—
P01193482
RAIL ROAD MEDICARE NUMBER
IL
Enumeration date
07/19/2011
Last updated
05/30/2025
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