Provider Demographics
NPI:1487615035
Name:UNWIN, JILL G (DC)
Entity type:Individual
Prefix:DR
First Name:JILL
Middle Name:G
Last Name:UNWIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:212 E VERONA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-1223
Mailing Address - Country:US
Mailing Address - Phone:608-848-1800
Mailing Address - Fax:608-848-1802
Practice Address - Street 1:212 E VERONA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1223
Practice Address - Country:US
Practice Address - Phone:608-848-1800
Practice Address - Fax:608-848-1802
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3193111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38909200Medicaid
WIU73592Medicare UPIN
WI38909200Medicaid