MEDICARE: JILL MARIE HOOTEN MS LCPC

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1841540572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL MARIE HOOTEN MS LCPC

Provider Business Mailing Address
First Line	:	1755 PARK ST
Second Line	:	SUITE 200
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-4861
Country	:	US
Telephone Number	:	630-854-6393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 PARK ST
Second Line	:	SUITE 200
City	:	NAPERVILLE
State	:	IL
Zip	:	60563-4861
Country	:	US
Telephone Number	:	630-854-6393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2012
Last Update Date	:	08/12/2013

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