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General NPI Number Information
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NPI Number | 1801864939
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Entity Type | Individual
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Provider Name | JILL EILEEN FERREE ATC, LAT
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Gender | Female
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4436 MAIN ST
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-2867
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Country | US
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Telephone | 630-795-8186
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Fax | 630-795-8099
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Provider Business Mailing Address
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Address Line | 8124 PADDINGTON RD
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City | WOODRIDGE
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State | IL
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Zip | 60517-4632
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Country | US
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Telephone | 630-400-5904
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Fax | 630-795-8099
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | IL
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