Provider Demographics
NPI:1861832958
Name:RHEE, JENNIFER JIYUN (PTA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JIYUN
Last Name:RHEE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6840 W TOUHY AVE
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:IL
Mailing Address - Zip Code:60714-4520
Mailing Address - Country:US
Mailing Address - Phone:847-647-6400
Mailing Address - Fax:
Practice Address - Street 1:6840 W TOUHY AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:IL
Practice Address - Zip Code:60714-4520
Practice Address - Country:US
Practice Address - Phone:847-647-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL160.005544225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant