Healthcare Provider Details

I. General information

NPI: 1649155078
Provider Name (Legal Business Name): JILLIAN MESSNER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 S MARION ST
OAK PARK IL
60302-3257
US

IV. Provider business mailing address

3553 N SOUTHPORT AVE APT 3
CHICAGO IL
60657-6994
US

V. Phone/Fax

Practice location:
  • Phone: 312-415-5507
  • Fax:
Mailing address:
  • Phone: 224-422-6776
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: