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General NPI Number Information
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NPI Number | 1487783270
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Entity Type | Individual
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Provider Name | JILL RENEE SOBCZYK P.A.-C
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 201 RIDGE ST SUITE 201
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4643
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Country | US
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Telephone | 712-322-5899
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Fax | 712-322-5730
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Provider Business Mailing Address
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Address Line | 808 E PIERCE ST
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4601
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Country | US
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Telephone | 712-396-4340
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Fax | 712-396-4180
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 001791
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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