Provider Demographics
NPI:1356440051
Name:NYE, JILL ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:JILL
Middle Name:ANN
Last Name:NYE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:ANN
Other - Last Name:MAROVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:14486 CREEK CROSSING DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467
Mailing Address - Country:US
Mailing Address - Phone:708-460-7840
Mailing Address - Fax:
Practice Address - Street 1:10257 W LINCOLN HIGHWAY
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423
Practice Address - Country:US
Practice Address - Phone:815-469-1117
Practice Address - Fax:815-469-1103
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist