Active NPI
Jill Hickman, PT
- Physical Therapist
- Galesburg, IL
National Provider Identifier
1124076476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-008671
- Practice address
- 865 N Kellogg St
3Rd Floor
Galesburg, IL 61401-2810 - Phone
- (309) 343-3434
- Fax
- (309) 343-3456
- NPI assigned
- May 5, 2006
- Last updated
- Apr 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-008671 | IL | Primary |
Addresses
Primary practice location
865 N Kellogg St
3Rd Floor
Galesburg, IL 61401-2810
Mailing address
PO Box 5387
Bloomington, IL 61702-5387
Phone (309) 661-8823
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 070-008671 | Other | IL | IL LICENSE NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-008671 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303257600000",
"number": "1124076476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5387",
"city": "BLOOMINGTON",
"state": "IL",
"postal_code": "617025387",
"telephone_number": "309-661-8823",
"fax_number": "309-661-8801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "865 N KELLOGG ST",
"address_2": "3RD FLOOR",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614012810",
"telephone_number": "309-343-3434",
"fax_number": "309-343-3456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKMAN",
"first_name": "JILL",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2011-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-008671",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IL LICENSE NO",
"identifier": "070-008671",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Galesburg, IL
- Kate Herbert, SLP
- Justin Hering, MD
- Jeffrey D Hershkowitz, D.O.
- Robert Hickerson
- Kevin D Hickey, R.PH.
- Highland Park CVS LLC (CVS Pharmacy #16324)
- Jennifer L. Hoben, SLP
- Shana Rae Holman, FNP
- Hope Harmony & Holistic Health Counseling Center (Wild Moon Counseling)
- Hospital Care Consultants of Galesburg, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.