Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 070.010806 | IL |
Y | 2251N0400X | Physical Therapist - Neurology | 070.010806 | IL |
NPI | 1538479712 |
---|---|
Provider Name | Jennifer Lynne Ford |
First Address | Arlington Heights, IL 60005-3135 |
Second Address | Arlington Heights, IL 60005-3135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2010 |
Last Update Date | 20/10/2010 |