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NPI Code Detail

MEDICARE: MS. JILL E. KOREY OTRL

MEDICARE:  MS. JILL E. KOREY  OTRL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational TherapistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104932193OTHERILBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1225152416
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JILL E. KOREY OTRL
Provider Business Mailing Address
First Line : 1450 OLD SKOKIE RD
Second Line :
City : HIGHLAND PARK
State : IL
Zip : 60035-3032
Country : US
Telephone Number : 847-831-1477
Fax Number : 847-831-1336
Provider Business Practice Location Address
First Line : 1450 OLD SKOKIE RD
Second Line :
City : HIGHLAND PARK
State : IL
Zip : 60035-3032
Country : US
Telephone Number : 847-831-1477
Fax Number : 847-831-1336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ MS. JILL E. KOREY OTRL” Practice Location

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