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General NPI Number Information
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NPI Number | 1265528293
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Entity Type | Individual
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Provider Name | JILL MARIE OBBAGY MS
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Gender | Female
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 05/04/2025
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Provider Practice Location Address
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Address Line | 15255 S 94TH AVE
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City | ORLAND PARK
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State | IL
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Zip | 60462-3800
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Country | US
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Telephone | 217-779-0148
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 TATE DR
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City | SCHERERVILLE
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State | IN
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Zip | 46375-6009
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Country | US
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Telephone | 217-779-0148
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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