Provider Demographics
NPI:1073589511
Name:RONDINI, JILL RENE (AT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:RENE
Last Name:RONDINI
Suffix:
Gender:F
Credentials:AT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27825 DETROIT RD APT 413
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2186
Mailing Address - Country:US
Mailing Address - Phone:440-935-3870
Mailing Address - Fax:
Practice Address - Street 1:200 WOODLAND ST
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1051
Practice Address - Country:US
Practice Address - Phone:440-775-8568
Practice Address - Fax:440-775-8616
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAT17742255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer