Provider Demographics
NPI:1497264493
Name:MUELLER, JENA N (DPT)
Entity Type:Individual
Prefix:
First Name:JENA
Middle Name:N
Last Name:MUELLER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JENA
Other - Middle Name:N
Other - Last Name:MOELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:600 OAKMONT LN STE 600C
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5548
Mailing Address - Country:US
Mailing Address - Phone:630-575-6200
Mailing Address - Fax:
Practice Address - Street 1:7592 COX LN
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6519
Practice Address - Country:US
Practice Address - Phone:513-233-7400
Practice Address - Fax:513-755-1200
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070023381225100000X
OHPT017183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist