IndividualActive
Jenifer De Lara, PT
NPI 1255654950 · Geriatric Physical Therapist · Evanston, IL
Provider details
- NPI number
- 1255654950
- Entity type
- Individual
- Primary specialty
- Geriatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Female
- Sole proprietor
- No
- License
- 070-009035 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1415 Sherman Ave
Apt. 605
Evanston, IL 60201-4453
Phone: (773) 817-2522
Approximate (ZIP-level) locationGet directions
Mailing address
1415 Sherman Avenue #605
Evanston, IL 60201
Registry dates
- Enumerated
- 2010-03-09
- Last updated
- 2010-03-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.