Healthcare Provider Details

I. General information

NPI: 1295643021
Provider Name (Legal Business Name): JILL ELLEN DIMON RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 UNIVERSITY AVE
WINDSOR HEIGHTS IA
50324-1436
US

IV. Provider business mailing address

8220 SUTTON DR
URBANDALE IA
50322-7382
US

V. Phone/Fax

Practice location:
  • Phone: 515-279-4408
  • Fax: 515-279-9691
Mailing address:
  • Phone: 515-343-9196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17434
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: