Provider Demographics
NPI:1639352255
Name:OERTLE, JILL ROBYN (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:ROBYN
Last Name:OERTLE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:BUNKER HILL
Mailing Address - State:IL
Mailing Address - Zip Code:62014-0326
Mailing Address - Country:US
Mailing Address - Phone:618-585-4761
Mailing Address - Fax:618-585-3523
Practice Address - Street 1:128 NORTH WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BUNKER HILL
Practice Address - State:IL
Practice Address - Zip Code:62014
Practice Address - Country:US
Practice Address - Phone:618-585-4761
Practice Address - Fax:618-585-3523
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070012406225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5932026OtherBLUE CROSS BLUE SHIELD OF ILLINOIS
708779OtherOPTUM HEALTH / ACN
IL7645410OtherAETNA
IL921345OtherHEALTHLINK
ILP00652253OtherRAILROAD MEDICARE
2602740OtherUNITED HEALTHCARE
IL921345OtherHEALTHLINK