Provider Demographics
NPI:1376943845
Name:MALETIC, JASMINE M (MSPT)
Entity Type:Individual
Prefix:MRS
First Name:JASMINE
Middle Name:M
Last Name:MALETIC
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9228 N COURTLAND DR
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-1328
Mailing Address - Country:US
Mailing Address - Phone:847-226-3822
Mailing Address - Fax:
Practice Address - Street 1:9228 N COURTLAND DR
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-1328
Practice Address - Country:US
Practice Address - Phone:847-226-3822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012182225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist