Healthcare Provider Details

I. General information

NPI: 1558885038
Provider Name (Legal Business Name): JILLIAN PEHRSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILLIAN THOMPSON

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

823 W MICHIGAN AVE
MARSHALL MI
49068-1445
US

IV. Provider business mailing address

2122 YORK RD STE 300
OAK BROOK IL
60523-1925
US

V. Phone/Fax

Practice location:
  • Phone: 269-248-4300
  • Fax: 269-781-5505
Mailing address:
  • Phone: 630-575-6200
  • Fax: 630-928-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501018285
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: