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Individual

MS. JENNIFER CACCOMO MATARAZZO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
4139 N FIRESTONE CT, HOFFMAN ESTATES, IL 60192-1701
(847) 525-9556
(847) 220-9206
Mailing address
4139 N FIRESTONE CT, HOFFMAN ESTATES, IL 60192-1701
(847) 525-9556
(847) 220-9206

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070015636
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1617235
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/26/2007
Last updated
12/08/2011
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