Provider Demographics
NPI:1508039637
Name:BURKHARD, JILL ANN (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ANN
Last Name:BURKHARD
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4434 SUMMER DR
Mailing Address - Street 2:
Mailing Address - City:ZIONSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46077-8246
Mailing Address - Country:US
Mailing Address - Phone:317-769-6767
Mailing Address - Fax:
Practice Address - Street 1:4434 SUMMER DR
Practice Address - Street 2:
Practice Address - City:ZIONSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46077-8246
Practice Address - Country:US
Practice Address - Phone:317-769-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN320783225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist