Provider Demographics
NPI:1306028782
Name:MCGRIFF, JILLIAN M (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:M
Last Name:MCGRIFF
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 NORTH SHERIDAN ROAD
Mailing Address - Street 2:PATIENT ACCOUNTING
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614
Mailing Address - Country:US
Mailing Address - Phone:309-692-8110
Mailing Address - Fax:309-692-8673
Practice Address - Street 1:6501 NORTH SHERIDAN ROAD
Practice Address - Street 2:PATIENT ACCOUNTING
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614
Practice Address - Country:US
Practice Address - Phone:309-692-8110
Practice Address - Fax:309-692-8673
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist