Provider Demographics
NPI:1396032249
Name:REESE, JILL MARIE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:REESE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20900 WESTGATE
Mailing Address - Street 2:T2266
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1320
Mailing Address - Country:US
Mailing Address - Phone:216-325-0753
Mailing Address - Fax:216-325-0763
Practice Address - Street 1:20900 WESTGATE
Practice Address - Street 2:T2266
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1320
Practice Address - Country:US
Practice Address - Phone:216-325-0753
Practice Address - Fax:216-325-0763
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03324011183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist