Provider Demographics
NPI:1316450224
Name:TABONE, JILL MARIE (MA, CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:MARIE
Last Name:TABONE
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:MS
Other - First Name:JILL
Other - Middle Name:MARIE
Other - Last Name:TABONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:2722 ACORN CT
Mailing Address - Street 2:
Mailing Address - City:WEST DUNDEE
Mailing Address - State:IL
Mailing Address - Zip Code:60118-1547
Mailing Address - Country:US
Mailing Address - Phone:847-826-9800
Mailing Address - Fax:
Practice Address - Street 1:2722 ACORN CT
Practice Address - Street 2:
Practice Address - City:WEST DUNDEE
Practice Address - State:IL
Practice Address - Zip Code:60118-1547
Practice Address - Country:US
Practice Address - Phone:847-826-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.004906235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist