Healthcare Provider Details

I. General information

NPI: 1306770243
Provider Name (Legal Business Name): JILL SPEER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 W DAYTON ST
MADISON WI
53703-1995
US

IV. Provider business mailing address

1726 ELKA LN
MADISON WI
53704-3338
US

V. Phone/Fax

Practice location:
  • Phone: 608-663-1879
  • Fax:
Mailing address:
  • Phone: 608-663-1879
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number24309830
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: