Provider Demographics
NPI:1720648876
Name:JONCOM PT,P.C.
Entity Type:Organization
Organization Name:JONCOM PT,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:COMEROUSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:630-404-1045
Mailing Address - Street 1:5N425 EAGLE TER
Mailing Address - Street 2:
Mailing Address - City:ITASCA
Mailing Address - State:IL
Mailing Address - Zip Code:60143-2434
Mailing Address - Country:US
Mailing Address - Phone:630-404-1045
Mailing Address - Fax:
Practice Address - Street 1:360 W BUTTERFIELD RD STE 150
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5099
Practice Address - Country:US
Practice Address - Phone:630-268-1045
Practice Address - Fax:630-268-1047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty