1720167885 NPI number — JOCELYN TAUTERIS ZOLNA-PITTS P.T.

Table of content: JOCELYN TAUTERIS ZOLNA-PITTS P.T. (NPI 1720167885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720167885 NPI number — JOCELYN TAUTERIS ZOLNA-PITTS P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZOLNA-PITTS
Provider First Name:
JOCELYN
Provider Middle Name:
TAUTERIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZOLNA
Provider Other First Name:
JOCELYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720167885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24014 W RENWICK RD STE F
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLAINFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60544-8708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-974-4378
Provider Business Mailing Address Fax Number:
630-515-1536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 S CLARK ST STE 1020
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60603-1858
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-974-4378
Provider Business Practice Location Address Fax Number:
630-515-1536
Provider Enumeration Date:
11/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  070014436 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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