Provider Demographics
NPI:1518436302
Name:SAYLOR, JODIE
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:SAYLOR
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 1:3600 WEINGART RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60051-7530
Mailing Address - Country:US
Mailing Address - Phone:815-712-7754
Mailing Address - Fax:
Practice Address - Street 1:3600 WEINGART RD
Practice Address - Street 2:
Practice Address - City:JOHNSBURG
Practice Address - State:IL
Practice Address - Zip Code:60051-7530
Practice Address - Country:US
Practice Address - Phone:815-712-7754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician