Provider Demographics
NPI:1356543748
Name:GILL-TAYLOR, VALERIE JEAN (DEVLOPMENTAL THERAPI)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:JEAN
Last Name:GILL-TAYLOR
Suffix:
Gender:F
Credentials:DEVLOPMENTAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 DONNINGTON DR
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2284
Mailing Address - Country:US
Mailing Address - Phone:773-531-3742
Mailing Address - Fax:708-720-2933
Practice Address - Street 1:6006 W 159TH ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452
Practice Address - Country:US
Practice Address - Phone:708-535-0933
Practice Address - Fax:708-614-9435
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services