Provider Demographics
NPI:1497991392
Name:ALIER, JILL MICHELLE (LMT, NCTMB)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MICHELLE
Last Name:ALIER
Suffix:
Gender:F
Credentials:LMT, NCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 BROADWAY AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MATTOON
Mailing Address - State:IL
Mailing Address - Zip Code:61938-4043
Mailing Address - Country:US
Mailing Address - Phone:217-258-5555
Mailing Address - Fax:217-235-3948
Practice Address - Street 1:1510 BROADWAY AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:MATTOON
Practice Address - State:IL
Practice Address - Zip Code:61938-4043
Practice Address - Country:US
Practice Address - Phone:217-258-5555
Practice Address - Fax:217-235-3948
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2008-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.006718174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist