Provider Demographics
NPI:1003335753
Name:BURKE, JILLANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILLANNE
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JILLANNE
Other - Middle Name:
Other - Last Name:SMILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:807 W 22ND ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-3301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:807 W 22ND ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19802-3301
Practice Address - Country:US
Practice Address - Phone:302-290-1587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2017-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ1-0002827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist