Individual
JILL C OBRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
102 S HENNEPIN AVE, DIXON, IL 61021-3013
(815) 285-8520
(815) 285-8903
Mailing address
405 CHARLES ST, MOUNT MORRIS, IL 61054-1646
(815) 734-6061
(815) 734-9021
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-004480
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209004480
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400458270
MEDICARE PTAN
IL
Enumeration date
04/10/2008
Last updated
12/12/2024
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