Provider Demographics
NPI:1225152416
Name:KOREY, JILL E (OTRL)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:E
Last Name:KOREY
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 OLD SKOKIE RD
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-3032
Mailing Address - Country:US
Mailing Address - Phone:847-831-1477
Mailing Address - Fax:847-831-1336
Practice Address - Street 1:1450 OLD SKOKIE RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-3032
Practice Address - Country:US
Practice Address - Phone:847-831-1477
Practice Address - Fax:847-831-1336
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04932193OtherBCBS PROVIDER NUMBER