Provider Demographics
NPI:1437446796
Name:SPARACIO, JILL O (OTR/L, ATP)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:O
Last Name:SPARACIO
Suffix:
Gender:F
Credentials:OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 ROSLYN RD
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5809
Mailing Address - Country:US
Mailing Address - Phone:630-964-2871
Mailing Address - Fax:
Practice Address - Street 1:4600 ROSLYN RD
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5809
Practice Address - Country:US
Practice Address - Phone:630-964-2871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056-000761225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist