Healthcare Provider Details

I. General information

NPI: 1396415345
Provider Name (Legal Business Name): TILLIA R DILLON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD STE 870
HOFFMAN ESTATES IL
60169-7266
US

IV. Provider business mailing address

245 S PARK LN UNIT 214
PALATINE IL
60074-6443
US

V. Phone/Fax

Practice location:
  • Phone: 847-648-9204
  • Fax:
Mailing address:
  • Phone: 224-814-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number152.003506
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: