Provider Demographics
NPI:1689787616
Name:NORTON, JENNIFER GAY (MS, PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:GAY
Last Name:NORTON
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
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Mailing Address - Street 1:1506 BIRCH CT
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-5576
Mailing Address - Country:US
Mailing Address - Phone:618-550-9479
Mailing Address - Fax:618-656-9906
Practice Address - Street 1:1506 BIRCH CT
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-5576
Practice Address - Country:US
Practice Address - Phone:618-550-9479
Practice Address - Fax:618-656-9906
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL06032172OtherBLUECROSS BLUESHIELD-IL
7432812OtherAETNA
785079OtherHEALTHLINK
276922OtherGHP