Provider Demographics
NPI:1558509208
Name:REILAND, JILL (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:REILAND
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:IL
Mailing Address - Zip Code:60150-9771
Mailing Address - Country:US
Mailing Address - Phone:630-890-0854
Mailing Address - Fax:
Practice Address - Street 1:510 N 3RD ST
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:IL
Practice Address - Zip Code:60150-9771
Practice Address - Country:US
Practice Address - Phone:630-890-0854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-02
Last Update Date:2009-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056.008100225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist