| Jill Corder Llc | |
|
189 E Us Highway 40 Troy IL 62294-2266 | |
| (618) 973-7139 | |
| (618) 505-5044 |
| Full Name | Jill Corder Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 189 E Us Highway 40, Troy, Illinois |
| Authorized Official Name and Position | Jill Suzanne Corder (OWNER) |
| Authorized Official Contact | 6189737139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jill Corder Llc 189 E Us Highway 40 Troy IL 62294-2266 Ph: (618) 973-7139 | Jill Corder Llc 189 E Us Highway 40 Troy IL 62294-2266 Ph: (618) 973-7139 |
| NPI Number | 1346950615 |
|---|---|
| Provider Enumeration Date | 11/28/2022 |
| Last Update Date | 11/28/2022 |
| Certification Date | 11/28/2022 |
| Medicare PECOS PAC ID | 6305217332 |
|---|---|
| Medicare Enrollment ID | O20230130001206 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346950615 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Jill Suzanne Corder |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447464367 PECOS PAC ID: 7113398140 Enrollment ID: I20230130001357 |
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