Individual
JILL MAREE GRESHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP/L
Contact information
Practice address
107 TREMONT ST, HOPEDALE, IL 61747-7525
(309) 449-3321
Mailing address
18 WILSHIRE WOOD DR, MACKINAW, IL 61755-9793
(309) 359-8270
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
146004898
IL
Other
Enumeration date
03/08/2010
Last updated
03/08/2010
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