Provider Demographics
NPI:1619063880
Name:FRANCIS, JEFFREY (PT, MSPT)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:PT, MSPT
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:FRANCIS
Other - Last Name:ISRAEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:611 S WELLS ST #2405
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60607-4782
Mailing Address - Country:US
Mailing Address - Phone:312-725-0435
Mailing Address - Fax:
Practice Address - Street 1:611 S WELLS ST #2405
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4782
Practice Address - Country:US
Practice Address - Phone:312-725-0435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070014471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist