Provider Demographics
NPI:1437590460
Name:GARCIA, JENNIFER ELAINE
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ELAINE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4754 HILL TRAIL RD APT 3A
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-3819
Mailing Address - Country:US
Mailing Address - Phone:630-215-6596
Mailing Address - Fax:
Practice Address - Street 1:1288 STONEHAVEN CIR
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8409
Practice Address - Country:US
Practice Address - Phone:708-715-2555
Practice Address - Fax:630-429-9411
Is Sole Proprietor?:No
Enumeration Date:2013-07-06
Last Update Date:2013-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist