Provider Demographics
NPI:1912078791
Name:YORKE, JODI LYNN (PT, MHS)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:LYNN
Last Name:YORKE
Suffix:
Gender:F
Credentials:PT, MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:922 W SUNNYSIDE AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-6022
Mailing Address - Country:US
Mailing Address - Phone:773-294-9725
Mailing Address - Fax:
Practice Address - Street 1:610 S MAPLE AVE STE 5900
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60304-2814
Practice Address - Country:US
Practice Address - Phone:708-358-1612
Practice Address - Fax:708-358-1712
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist