Jill Anspach
Individual provider Active NPI Specialist · Delton, MI
NPI 1124298948 · NPPES record last updated Mar 7, 2008
Key facts
- NPI
- 1124298948
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- OT 9870 (CA)
- Practice address
- 11185 E Shore Dr
Delton, MI 49046-9406 - Phone
- (269) 615-6848
- NPI assigned
- Mar 7, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 9870 | CA | MD | Specialist |
| 056.008154 | IL | MD | Specialist |
| 5201007021 | MI | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 5201007021 | MI | |
| Specialist | 174400000X | OT 9870 | CA | Yes |
| Specialist | 174400000X | IL |
Addresses
Primary practice location
11185 E Shore Dr
Delton, MI 49046-9406
Mailing address
11185 E Shore Dr
Delton, MI 49046-9406
Phone (269) 615-6848
Other providers in Delton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.