Provider Demographics
NPI:1275904336
Name:BELZER, JEANNETTE (LMT)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:
Last Name:BELZER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1283 W DUNDEE RD
Mailing Address - Street 2:
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-4009
Mailing Address - Country:US
Mailing Address - Phone:847-632-9919
Mailing Address - Fax:773-337-9106
Practice Address - Street 1:202 S ROUTE 31
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-5415
Practice Address - Country:US
Practice Address - Phone:815-344-1192
Practice Address - Fax:773-337-9106
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227006362225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist