Provider Demographics
NPI:1205236569
Name:PILLARD, JANELLE (PA-C)
Entity type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:
Last Name:PILLARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GENESEO
Mailing Address - State:IL
Mailing Address - Zip Code:61254-1099
Mailing Address - Country:US
Mailing Address - Phone:309-935-4100
Mailing Address - Fax:309-935-4120
Practice Address - Street 1:203 W FRONT ST
Practice Address - Street 2:
Practice Address - City:ANNAWAN
Practice Address - State:IL
Practice Address - Zip Code:61234-7756
Practice Address - Country:US
Practice Address - Phone:309-935-4100
Practice Address - Fax:309-935-4120
Is Sole Proprietor?:No
Enumeration Date:2014-08-23
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical