Provider Demographics
NPI:1982295457
Name:JACKSON-HILL, REENEE (ABA)
Entity Type:Individual
Prefix:
First Name:REENEE
Middle Name:
Last Name:JACKSON-HILL
Suffix:
Gender:F
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 ATHENS RD
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1955
Mailing Address - Country:US
Mailing Address - Phone:708-573-1800
Mailing Address - Fax:708-283-1806
Practice Address - Street 1:2517 ATHENS RD
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1955
Practice Address - Country:US
Practice Address - Phone:708-573-1800
Practice Address - Fax:708-283-1806
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health