Mikelson, Jason Erik

Mikelson, Jason Erik is an individual health care provider with primary practice located at 2000 W State St Ste F , Geneva IL 60134-3696. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Mikelson, Jason Erik can be contacted via phone (877) 632-6637.

Contact Information

Primary practice address
2000 W State St Ste F Geneva IL 60134-3696
Phone: (877) 632-6637
Fax: (708) 409-5179
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070-011509 Illinois

Profile Details

NPI number 1336296045
LBN Legal business name Mikelson, Jason Erik
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Dec 13th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336296045 NPPES
Illinois Other 070-011509 PT STATE LICENSE #

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