Provider Demographics
NPI:1457408502
Name:SMILEY, JILL RACHEL (ATC)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:RACHEL
Last Name:SMILEY
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 W CUYLER AVE # 3E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1917
Mailing Address - Country:US
Mailing Address - Phone:773-472-7069
Mailing Address - Fax:
Practice Address - Street 1:1 STEVENSON DR
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2824
Practice Address - Country:US
Practice Address - Phone:847-634-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
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