Individual
MRS. JENNIFER MARIE MASTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, ATC
Contact information
Practice address
5221 N BROADWAY ST, CHICAGO, IL 60640-2303
(773) 784-9406
(773) 784-9401
Mailing address
4184 N CLARENDON AVE, #1N, CHICAGO, IL 60613-2227
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
070-012420
IL
2251S0007X
Sports Physical Therapist
070-012420
IL
2251X0800X
Orthopedic Physical Therapist
Primary
070-012420
IL
2255A2300X
Athletic Trainer
096-001603
IL
Other
Enumeration date
03/14/2006
Last updated
07/08/2015
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