Provider Demographics
NPI:1235383324
Name:BURDEN, JILL ANNE (DO)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:ANNE
Last Name:BURDEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANNE
Other - Last Name:ORLIKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:215 S ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2325
Mailing Address - Country:US
Mailing Address - Phone:231-620-1867
Mailing Address - Fax:
Practice Address - Street 1:1105 6TH ST
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-2349
Practice Address - Country:US
Practice Address - Phone:231-620-1867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-16
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.122603207P00000X
MI5101018011207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine