Provider Demographics
NPI:1659536118
Name:VANBUSKIRK, JAIME LYNN (PT, DPT, COMT, CMTPT)
Entity Type:Individual
Prefix:MS
First Name:JAIME
Middle Name:LYNN
Last Name:VANBUSKIRK
Suffix:
Gender:F
Credentials:PT, DPT, COMT, CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15632 CENTENNIAL CT
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-4571
Mailing Address - Country:US
Mailing Address - Phone:773-718-3814
Mailing Address - Fax:844-908-9499
Practice Address - Street 1:3938 W 111TH ST STE 1B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60655
Practice Address - Country:US
Practice Address - Phone:773-629-6875
Practice Address - Fax:844-965-9380
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist