Provider Demographics
NPI:1134318512
Name:ZEGLIS, JILL MEREDITH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:MEREDITH
Last Name:ZEGLIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 N SANDBURG TER
Mailing Address - Street 2:#3203
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-1351
Mailing Address - Country:US
Mailing Address - Phone:312-787-2951
Mailing Address - Fax:
Practice Address - Street 1:1560 N SANDBURG TER
Practice Address - Street 2:#3203
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-1351
Practice Address - Country:US
Practice Address - Phone:312-787-2951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical