Provider Demographics
NPI:1609862937
Name:PASEK, JILL HANSON (SLP)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:HANSON
Last Name:PASEK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JILL
Other - Middle Name:ANNETTE
Other - Last Name:HANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1720 S CLIFF AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-2129
Mailing Address - Country:US
Mailing Address - Phone:605-334-5630
Mailing Address - Fax:605-332-5327
Practice Address - Street 1:1720 S CLIFF AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-2129
Practice Address - Country:US
Practice Address - Phone:605-334-5630
Practice Address - Fax:605-332-5327
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN5427235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD617S5PAOtherBLUE CROSS BLUE SHIELD MN
SD64-00704OtherMEDICA
SD5834053Medicaid
SD5834052Medicaid
SD64-00705OtherMEDICA
SD64-00706OtherMEDICA
SD46-00863OtherMEDICA
SD5834054Medicaid
SD31681OtherSIOUX VALLEY HEALTH PLANS
SD5834050Medicaid
SD1907876OtherARAZ