Provider Demographics
NPI:1053758763
Name:JJA THERAPIES INC
Entity type:Organization
Organization Name:JJA THERAPIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:B
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:773-738-6365
Mailing Address - Street 1:500 W SUPERIOR ST
Mailing Address - Street 2:#2204
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-8132
Mailing Address - Country:US
Mailing Address - Phone:773-738-6365
Mailing Address - Fax:
Practice Address - Street 1:500 W SUPERIOR ST
Practice Address - Street 2:#2204
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-8132
Practice Address - Country:US
Practice Address - Phone:773-738-6365
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.007801225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty