Provider Demographics
NPI:1124148283
Name:WHEELER, JILL SUZANNE (DC)
Entity type:Individual
Prefix:MR
First Name:JILL
Middle Name:SUZANNE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5988
Mailing Address - Street 2:DEPT. 20-5030
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5988
Mailing Address - Country:US
Mailing Address - Phone:630-468-1824
Mailing Address - Fax:630-468-1834
Practice Address - Street 1:281 W TOWNLINE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-4334
Practice Address - Country:US
Practice Address - Phone:224-207-4060
Practice Address - Fax:630-468-1834
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4932806OtherBCBS
IL4932806OtherBCBS