Jennifer Lynne Smith, PTA, ATC, NCMT

Physical Therapy Assistant · Sandwich, IL

Individual Active NPI

NPI number 1104077015

Practice location

1310 N Main St Ste 100
Sandwich, IL 60548-1394
Phone
(815) 786-6000
Fax
(815) 786-3603

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NPI record

NPI
1104077015
Entity type
Individual (Type 1)
Enumeration date
October 9, 2008
Last updated
March 17, 2018
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physical Therapy Assistant Primary 225200000X 160-007698 IL
Rehabilitation Practitioner 225400000X — —

Mailing address

1952 Aberdeen Ct
Sycamore, IL 60178-3175
Phone
(815) 758-0000
Fax
(815) 748-3014

Other practice locations (1)

  • 2111 Midlands Ct, Sycamore, IL 60178-3125 · (815) 758-0000

About Jennifer Smith

Jennifer Lynne Smith, PTA, ATC, NCMT is a healthcare provider registered in the NPI registry with the primary taxonomy Physical Therapy Assistant (code 225200000X). The practice location is 1310 N Main St Ste 100, Sandwich, IL 60548-1394. The NPI number 1104077015 was assigned on October 9, 2008 and the record was last updated on March 17, 2018.

Jennifer Smith lists a license in the registry: #160-007698 (IL) for Physical Therapy Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jennifer Lynne Smith, PTA, ATC, NCMT?

The NPI number is 1104077015.

What is the phone number of Jennifer Smith?

The phone number listed for the practice location is (815) 786-6000.

Where is Jennifer Smith located?

1310 N Main St Ste 100, Sandwich, IL 60548-1394.

What is the taxonomy code for Jennifer Smith?

The primary taxonomy code is 225200000X – Physical Therapy Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.