Provider Demographics
NPI:1174604243
Name:HRABINSKY, JILL MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:HRABINSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:TAKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:49253 HWY M26
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930
Mailing Address - Country:US
Mailing Address - Phone:906-483-0798
Mailing Address - Fax:
Practice Address - Street 1:56901 S 6TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:CALUMET
Practice Address - State:MI
Practice Address - Zip Code:49913-2946
Practice Address - Country:US
Practice Address - Phone:906-337-1100
Practice Address - Fax:906-337-3869
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501006289225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650C157010OtherBLUE CROSS BLUE SHIELD
DD6320OtherRAILROAD MEDICARE
MI10 4565600Medicaid
DD6320OtherRAILROAD MEDICARE
MIN72240001Medicare ID - Type Unspecified