Individual
MRS. JILL RAE MICHALAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BC-HID
Contact information
Practice address
6555 WILLOW SPRINGS RD, SUITE 11, LA GRANGE HIGHLANDS, IL 60525-4591
(708) 579-9458
(708) 579-9561
Mailing address
916 E ELM ST, GRIFFITH, IN 46319-2806
(219) 838-6659
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2830
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633818
BLUE CROSS BLUE SHIELD
IL
Enumeration date
03/07/2007
Last updated
07/08/2007
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