Provider Demographics
NPI:1659494789
Name:DOWNIE, JESSICA STEIN
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:STEIN
Last Name:DOWNIE
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 1:1949 W CORTLAND ST
Mailing Address - Street 2:1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1041
Mailing Address - Country:US
Mailing Address - Phone:773-276-4348
Mailing Address - Fax:
Practice Address - Street 1:1949 W CORTLAND ST
Practice Address - Street 2:1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1041
Practice Address - Country:US
Practice Address - Phone:773-276-4348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist