Provider Demographics
NPI:1700221132
Name:HEMMELGARN, JILL E (DO)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:E
Last Name:HEMMELGARN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JILL
Other - Middle Name:E
Other - Last Name:THREEWITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:750 W HIGH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-3961
Mailing Address - Country:US
Mailing Address - Phone:419-227-1359
Mailing Address - Fax:
Practice Address - Street 1:750 W HIGH ST STE 150
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801
Practice Address - Country:US
Practice Address - Phone:419-227-1359
Practice Address - Fax:419-227-7586
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101020342207R00000X
OH34013268207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine