Jenifer Carlos De Lara
Physical Therapist - Geriatrics
1415 Sherman Ave Apt. 605
Evanston
, Illinois 60201-4453
Jenifer Carlos De Lara
Physical Therapist - Geriatrics
1415 Sherman Ave Apt. 605
Evanston
, Illinois 60201-4453
(773) 817-2522
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About
Features
Specialties
- Physical Therapist - Geriatrics
Languages spoken
- English
Location
First Address
- Jenifer Carlos De Lara
- 1415 Sherman Avenue #605
- Evanston, IL
- Zip : 60201
- Phone : (773) 817-2522
Second Address
- Jenifer Carlos De Lara
- 1415 Sherman Ave Apt. 605
- Evanston, IL
- Zip : 60201-4453
- Phone : (773) 817-2522
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2251G0304X | Physical Therapist - Geriatrics | 070-009035 | IL |
National Provider Identifier
| NPI | 1255654950 |
|---|---|
| Provider Name | Jenifer Carlos De Lara |
| First Address | Evanston, IL 60201 |
| Second Address | Evanston, IL 60201-4453 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/03/2010 |
| Last Update Date | 09/03/2010 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.