Provider Demographics
NPI:1144362039
Name:GREENFIELD, JILL R (PT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:R
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2001 BUTTERFIELD RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1211
Mailing Address - Country:US
Mailing Address - Phone:866-370-8206
Mailing Address - Fax:517-435-3670
Practice Address - Street 1:830 COTTAGEVIEW DR, SUITE 204
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-1631
Practice Address - Country:US
Practice Address - Phone:231-486-0326
Practice Address - Fax:231-244-1716
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216790225100000X
SC12627225100000X
PAPT032789225100000X
DCPT210002507225100000X
IN05015800A225100000X
GAPT017485225100000X
NCP23659225100000X
MI5501002654225100000X
MAPTL28049225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist