Individual
JILL K. SHACKELFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
40W310 LAFOX RD, SUITE 1A, ST CHARLES, IL 60175-6588
(630) 444-0077
(630) 444-0078
Mailing address
638 S CROSS ST, SYCAMORE, IL 60178-2111
(630) 444-0077
(630) 444-0078
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146006263
IL
Other
Enumeration date
01/10/2007
Last updated
11/06/2013
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