Provider Demographics
NPI:1992829444
Name:SAAK, JEANNETTE M (MS ED, LPTA)
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:M
Last Name:SAAK
Suffix:
Gender:F
Credentials:MS ED, LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BENHAM DR
Mailing Address - Street 2:
Mailing Address - City:MILLSTADT
Mailing Address - State:IL
Mailing Address - Zip Code:62260-2270
Mailing Address - Country:US
Mailing Address - Phone:618-977-7733
Mailing Address - Fax:
Practice Address - Street 1:901 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MASCOUTAH
Practice Address - State:IL
Practice Address - Zip Code:62258-1017
Practice Address - Country:US
Practice Address - Phone:618-566-8195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant