Provider Demographics
NPI:1497478887
Name:PILLER, ALEXIS AMELIA
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:AMELIA
Last Name:PILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6754 ARMER DR
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61109-4800
Mailing Address - Country:US
Mailing Address - Phone:815-332-4938
Mailing Address - Fax:
Practice Address - Street 1:6754 ARMER DR
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61109-4800
Practice Address - Country:US
Practice Address - Phone:818-332-4938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.007026235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist