Provider Demographics
NPI:1790023026
Name:JUMAMIL, MARLOU (PT)
Entity Type:Individual
Prefix:
First Name:MARLOU
Middle Name:
Last Name:JUMAMIL
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 1:8613 N MILWAUKEE AVE
Mailing Address - Street 2:APT 1W
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 E GOLF RD
Practice Address - Street 2:SUITE 2133
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-5222
Practice Address - Country:US
Practice Address - Phone:847-593-9771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1300016209174400000X
TX1303400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist