Provider Demographics
NPI:1285901751
Name:HILLMANN PEDIATRIC THERAPY
Entity type:Organization
Organization Name:HILLMANN PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLMANN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:815-730-1800
Mailing Address - Street 1:941 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LA SALLE
Mailing Address - State:IL
Mailing Address - Zip Code:61301-2205
Mailing Address - Country:US
Mailing Address - Phone:815-224-3261
Mailing Address - Fax:815-224-4512
Practice Address - Street 1:941 6TH ST
Practice Address - Street 2:
Practice Address - City:LA SALLE
Practice Address - State:IL
Practice Address - Zip Code:61301-2205
Practice Address - Country:US
Practice Address - Phone:815-224-3261
Practice Address - Fax:815-224-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL057003453282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural