Healthcare Provider Details

I. General information

NPI: 1366844227
Provider Name (Legal Business Name): JILL BALLARD PAGE MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2014
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 BRIARGATE DR STE 700
SOUTH ELGIN IL
60177-2284
US

IV. Provider business mailing address

460 BRIARGATE DR STE 700
SOUTH ELGIN IL
60177-2284
US

V. Phone/Fax

Practice location:
  • Phone: 847-488-1999
  • Fax: 847-488-9797
Mailing address:
  • Phone: 847-488-1999
  • Fax: 847-488-9797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.020203
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: