Provider Demographics
NPI:1174722284
Name:SAVINO, JILLIAN M (PT)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:M
Last Name:SAVINO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 S 1ST AVE
Mailing Address - Street 2:404-1
Mailing Address - City:MAYWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60153-2442
Mailing Address - Country:US
Mailing Address - Phone:312-662-8777
Mailing Address - Fax:
Practice Address - Street 1:1701 S 1ST AVE
Practice Address - Street 2:404-1
Practice Address - City:MAYWOOD
Practice Address - State:IL
Practice Address - Zip Code:60153-2442
Practice Address - Country:US
Practice Address - Phone:312-662-8777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.012177225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL568080OtherMEDICARE GROUP NUMBER
IL1619980OtherBCBS OF IL
IL567700OtherMEDICARE GROUP NUMBER
IL568150OtherMEDICARE GROUP NUMBER
IL1619980OtherBCBS OF IL
ILR00506Medicare PIN
ILR00505Medicare PIN