Provider Demographics
NPI:1154494334
Name:JACHIMEK, JULIE M (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:JACHIMEK
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:PO BOX 713260
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-1260
Mailing Address - Country:US
Mailing Address - Phone:630-469-2000
Mailing Address - Fax:
Practice Address - Street 1:751 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1984
Practice Address - Country:US
Practice Address - Phone:815-215-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0700110752251S0007X, 2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00623067OtherMEDICARE RAILROAD NUMBER
IL4429630OtherAETNA
ILCD3789OtherMEDICARE RAILROAD GROUP NUMBER
IL354400405001Medicaid
IL1619908OtherBCBS IL GROUP
IL1620259OtherBLUE CROSS BLUE SHIELD
IL568150OtherMEDICARE GROUP NUMBER
IL1619908OtherBCBS IL GROUP
IL933090Medicare ID - Type Unspecified