Provider Demographics
NPI: | 1194029843 |
---|---|
Name: | HILLMANN, BRENDA J (PT) |
Entity type: | Individual |
Prefix: | |
First Name: | BRENDA |
Middle Name: | J |
Last Name: | HILLMANN |
Suffix: | |
Gender: | F |
Credentials: | PT |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 860 CENTER CT UNIT C |
Mailing Address - Street 2: | |
Mailing Address - City: | SHOREWOOD |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60404-8535 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 815-730-1800 |
Mailing Address - Fax: | 815-730-1835 |
Practice Address - Street 1: | 860 CENTER CT UNIT C |
Practice Address - Street 2: | |
Practice Address - City: | SHOREWOOD |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60404-8535 |
Practice Address - Country: | US |
Practice Address - Phone: | 815-773-9000 |
Practice Address - Fax: | 815-773-9001 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2011-01-10 |
Last Update Date: | 2025-07-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
225100000X, 2251P0200X, 2251X0800X, 225200000X, 225X00000X, 225XP0019X, 235Z00000X, 225XP0200X, 235Z00000X, 225XP0200X | ||
IL | 070.004687 | 225100000X, 2251P0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation |
No | 235Z00000X | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |