Provider Demographics
NPI:1700024718
Name:SWANSON, JILL E (DPT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:E
Last Name:SWANSON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 W WACKER DR
Mailing Address - Street 2:STE. 1020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1216
Mailing Address - Country:US
Mailing Address - Phone:312-640-0329
Mailing Address - Fax:312-640-0407
Practice Address - Street 1:2707 STANGE RD
Practice Address - Street 2:STE. 102
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3965
Practice Address - Country:US
Practice Address - Phone:515-956-4014
Practice Address - Fax:515-292-7200
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA004330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist