Provider Demographics
NPI:1366411654
Name:FRANCIS, JILL M (MS/ATC/L)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:M
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:MS/ATC/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20939 N 400 EAST RD
Mailing Address - Street 2:
Mailing Address - City:FLANAGAN
Mailing Address - State:IL
Mailing Address - Zip Code:61740-8970
Mailing Address - Country:US
Mailing Address - Phone:815-796-2935
Mailing Address - Fax:
Practice Address - Street 1:202 E FALCON HWY
Practice Address - Street 2:
Practice Address - City:FLANAGAN
Practice Address - State:IL
Practice Address - Zip Code:61740-7503
Practice Address - Country:US
Practice Address - Phone:815-796-2291
Practice Address - Fax:815-796-2856
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer