Provider Demographics
NPI:1801864939
Name:FERREE, JILL EILEEN (ATC, LAT)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:EILEEN
Last Name:FERREE
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8124 PADDINGTON RD
Mailing Address - Street 2:
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-4632
Mailing Address - Country:US
Mailing Address - Phone:630-400-5904
Mailing Address - Fax:630-795-8099
Practice Address - Street 1:4436 MAIN ST
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2867
Practice Address - Country:US
Practice Address - Phone:630-795-8186
Practice Address - Fax:630-795-8099
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer