Provider Demographics
NPI:1417182361
Name:HAHLEN, JILL LYNN (SLP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:LYNN
Last Name:HAHLEN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W FULTON ST APT 504
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1158
Mailing Address - Country:US
Mailing Address - Phone:312-545-4343
Mailing Address - Fax:
Practice Address - Street 1:560 W FULTON ST APT 504
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60661-1158
Practice Address - Country:US
Practice Address - Phone:312-545-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146009109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist