Provider Demographics
NPI:1679760375
Name:SAMONIS, JURGITA (PT)
Entity Type:Individual
Prefix:MRS
First Name:JURGITA
Middle Name:
Last Name:SAMONIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 31ST ST
Mailing Address - Street 2:STE. 300
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5509
Mailing Address - Country:US
Mailing Address - Phone:630-873-8860
Mailing Address - Fax:630-261-6901
Practice Address - Street 1:1801 S HIGHLAND AVE
Practice Address - Street 2:L10
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4932
Practice Address - Country:US
Practice Address - Phone:630-873-8860
Practice Address - Fax:630-261-6901
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70015919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209349Medicare UPIN
144528Medicare PIN