Healthcare Provider Details

I. General information

NPI: 1316689896
Provider Name (Legal Business Name): JILLIAN TAYLOR CREGGER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

557 SEMINOLE RD
NORTON SHORES MI
49444-3719
US

IV. Provider business mailing address

505 W GRAND AVE
MOUNT PLEASANT MI
48858-6001
US

V. Phone/Fax

Practice location:
  • Phone: 616-994-2270
  • Fax:
Mailing address:
  • Phone: 198-944-4236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601001250
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: