Individual
JILL M. REISMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3900 ST FRANCIS WAY STE 200, LAFAYETTE, IN 47905-4940
(765) 502-4000
(765) 402-4709
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10000734A
IN
363AM0700X
Medical Physician Assistant
Primary
10000734A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300008925
—
IN
Enumeration date
07/25/2006
Last updated
01/08/2026
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