Healthcare Provider Details

I. General information

NPI: 1831477843
Provider Name (Legal Business Name): JILL ELIZABETH PLACEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/25/2011
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 W CENTRAL RD SUITE 100A
ARLINGTON HEIGHTS IL
60005-2376
US

IV. Provider business mailing address

25 N WINFIELD RD STE 100A
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 847-392-9191
  • Fax: 847-392-9811
Mailing address:
  • Phone: 630-653-4240
  • Fax: 630-315-6597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number125060073
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: