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General NPI Number Information
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NPI Number | 1679741037
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Entity Type | Individual
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Provider Name | JILL E DOAN DDS MS
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Gender | Female
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 09/12/2011
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Provider Practice Location Address
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Address Line | 223 W JACKSON BLVD SUITE 1275
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City | CHICAGO
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State | IL
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Zip | 60606-6908
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Country | US
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Telephone | 312-588-0112
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Fax | 312-588-0398
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Provider Business Mailing Address
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Address Line | 223 W JACKSON BLVD SUITE 1275
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City | CHICAGO
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State | IL
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Zip | 60606-6972
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Country | US
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Telephone | 312-588-0112
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Fax | 312-588-0398
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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 | 019-027357
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 021-002235
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License Number State | IL
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