Organization
JILL A. PATTERSON, MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILL A. PATTERSON MD (PRESIDENT)
(708) 478-5763
Entity
Organization
Contact information
Practice address
11148 FRONT ST, MOKENA, IL 60448-1525
(708) 478-5763
(708) 478-8763
Mailing address
11148 FRONT ST, MOKENA, IL 60448-1525
(708) 478-5763
(708) 478-8763
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036084102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036084102
—
IL
01
—
1083642557
INDIVIDUAL NPI
IL
01
—
40755
MEDICARE GROUP PTAN
IL
Enumeration date
10/18/2010
Last updated
10/20/2010
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