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General NPI Number Information
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NPI Number | 1427278613
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Entity Type | Individual
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Provider Name | JILL SCHULER YOUNG D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 02/08/2011
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Provider Practice Location Address
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Address Line | 2100 E WASHINGTON ST
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City | BLOOMINGTON
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State | IL
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Zip | 61701-4321
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Country | US
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Telephone | 309-662-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 9 TAMI CT
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City | BLOOMINGTON
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State | IL
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Zip | 61701-2018
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019025316
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License Number State | IL
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