Provider Demographics
NPI:1114615960
Name:YORK, JENNIFER SUZANNE
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:YORK
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:SUZANNE
Other - Last Name:MAGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2110 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2515
Mailing Address - Country:US
Mailing Address - Phone:847-644-9197
Mailing Address - Fax:
Practice Address - Street 1:2110 PIONEER RD
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-2515
Practice Address - Country:US
Practice Address - Phone:847-644-9197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist