Provider Demographics
NPI:1124435144
Name:COHN, JENNA R (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:JENNA
Middle Name:R
Last Name:COHN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:JENNA
Other - Middle Name:R
Other - Last Name:LONCAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:997 N CORPORATE CIRCLE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030
Mailing Address - Country:US
Mailing Address - Phone:847-223-8001
Mailing Address - Fax:847-986-3580
Practice Address - Street 1:997 N CORPORATE CIRCLE
Practice Address - Street 2:SUITE B
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030
Practice Address - Country:US
Practice Address - Phone:847-223-8001
Practice Address - Fax:847-986-3580
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225100000X
IL070.020955225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist