Jillian Kilburn, LPC
Individual provider Active NPI Professional Counselor · Alsip, IL
NPI 1407347883 · NPPES record last updated Dec 7, 2021
Key facts
- NPI
- 1407347883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 6401020257 (MI)
- Practice address
- 12201 S Harding Ave
Alsip, IL 60803-1402 - Phone
- (708) 581-8506
- NPI assigned
- May 22, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 6401020257 | MI | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401020257 | MI | Yes |
Addresses
Primary practice location
12201 S Harding Ave
Alsip, IL 60803-1402
Mailing address
12201 S Harding Ave
Alsip, IL 60803-1402
NPI Registry JSON
{
"created_epoch": "1526947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638835200000",
"number": "1407347883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12201 S HARDING AVE",
"city": "ALSIP",
"state": "IL",
"postal_code": "608031402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12201 S HARDING AVE",
"city": "ALSIP",
"state": "IL",
"postal_code": "608031402",
"telephone_number": "708-581-8506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILBURN",
"first_name": "JILLIAN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-22",
"last_updated": "2021-12-07",
"certification_date": "2021-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401020257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alsip, IL
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2021. 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.