Provider Demographics
NPI:1164665121
Name:BOCHENEK, JENNIFER LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:BOCHENEK
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 1:1216 EAST CENTRAL RODAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2859
Mailing Address - Country:US
Mailing Address - Phone:847-222-0878
Mailing Address - Fax:847-222-1087
Practice Address - Street 1:1216 E CENTRAL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2860
Practice Address - Country:US
Practice Address - Phone:847-222-0878
Practice Address - Fax:847-222-1087
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070007667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist