Healthcare Provider Details

I. General information

NPI: 1740523539
Provider Name (Legal Business Name): JILL KATHERINE COTSEONES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2013
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N 3RD ST STE 100
GENEVA IL
60134-2388
US

IV. Provider business mailing address

25 N 3RD ST STE 100
GENEVA IL
60134-2388
US

V. Phone/Fax

Practice location:
  • Phone: 630-315-6500
  • Fax: 630-315-6519
Mailing address:
  • Phone: 630-315-6500
  • Fax: 630-315-6519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number036147037
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number126063661
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: