Provider Demographics
NPI:1730153057
Name:SKALING, JENNIFER L (PT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:SKALING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:337 75TH ST
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2366
Practice Address - Country:US
Practice Address - Phone:630-789-0004
Practice Address - Fax:630-789-0095
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011766L225100000X
IL070016406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL567700OtherMEDICARE GROUP NUMBER
IL568150OtherMEDICARE GROUP NUMBER
IL161998OtherBCBS OF IL
IL568080OtherMEDICARE GROUP NUMBER
IL567700OtherMEDICARE GROUP NUMBER