Provider Demographics
NPI:1407073521
Name:JONES, MARILYN RYNNING (OTR/L)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:RYNNING
Last Name:JONES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 WEST HARRISON STREET
Mailing Address - Street 2:SUITE 440
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3824
Mailing Address - Country:US
Mailing Address - Phone:312-563-2454
Mailing Address - Fax:312-563-2222
Practice Address - Street 1:1725 WEST HARRISON STREET
Practice Address - Street 2:RUSH UNIVERSITY MEDICAL CENTER SUITE 440
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3824
Practice Address - Country:US
Practice Address - Phone:312-563-2454
Practice Address - Fax:312-563-2222
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056002120225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist