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General NPI Number Information
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NPI Number | 1790467751
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Entity Type | Organization
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Legal Business Name | JILL M EARLY LLC
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Dates
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Enumeration Date | 08/01/2023
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Last Update Date | 04/23/2024
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Provider Practice Location Address
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Address Line | 703 EMMERT DR
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City | SYCAMORE
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State | IL
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Zip | 60178-2019
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Country | US
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Telephone | 630-947-4271
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Fax |
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Provider Business Mailing Address
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Address Line | 703 EMMERT DR
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City | SYCAMORE
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State | IL
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Zip | 60178-2019
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Country | US
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Telephone | 630-947-4271
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JILL EARLY
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Credential | LCSW
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Telephone | 630-947-4271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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