Provider Demographics
NPI:1306262191
Name:TUREK, JILL
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:TUREK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 S MARION ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44818-9201
Mailing Address - Country:US
Mailing Address - Phone:419-983-2711
Mailing Address - Fax:
Practice Address - Street 1:58 S MARION ST
Practice Address - Street 2:
Practice Address - City:BLOOMVILLE
Practice Address - State:OH
Practice Address - Zip Code:44818-9201
Practice Address - Country:US
Practice Address - Phone:419-983-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-17
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7401065Medicaid
OH0084965Medicaid