Provider Demographics
NPI:1235508029
Name:DILLOW, JON
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:DILLOW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 SUNFLOWER ST
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-7468
Mailing Address - Country:US
Mailing Address - Phone:217-390-8922
Mailing Address - Fax:
Practice Address - Street 1:114 SUNFLOWER ST
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-7468
Practice Address - Country:US
Practice Address - Phone:217-390-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral