Provider Demographics
NPI:1518299742
Name:NOLDEN, JAMIE N (PT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:NOLDEN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:N
Other - Last Name:LAPENNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:SUITE 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:
Practice Address - Street 1:329 75TH ST
Practice Address - Street 2:
Practice Address - City:WILLOWBROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2366
Practice Address - Country:US
Practice Address - Phone:630-789-0004
Practice Address - Fax:630-789-0095
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070017600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist