Provider Demographics
NPI:1407214851
Name:DIRILTEN, JILL (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:DIRILTEN
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3308 TALL GRASS DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60564-4445
Mailing Address - Country:US
Mailing Address - Phone:708-743-6767
Mailing Address - Fax:630-922-3784
Practice Address - Street 1:3308 TALL GRASS DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-4445
Practice Address - Country:US
Practice Address - Phone:708-743-6767
Practice Address - Fax:630-922-3784
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-31
Last Update Date:2016-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146-007342235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist