Provider Demographics
NPI:1013130525
Name:VOLLBRECHT, JILL ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:ELIZABETH
Last Name:VOLLBRECHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5015 N ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-9292
Mailing Address - Country:US
Mailing Address - Phone:231-935-0850
Mailing Address - Fax:231-935-0869
Practice Address - Street 1:5015 N ROYAL DR
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-9292
Practice Address - Country:US
Practice Address - Phone:231-935-0850
Practice Address - Fax:231-935-0850
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083009207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B86016116Medicare PIN