Jill M Egizio, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149011902 Issued in IL

Practice address

7717 N Orange Prairie Rd
Peoria, IL 61615-9323

Phone

(309) 589-6800

NPI assigned

Jan 30, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Danville Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Peoria, IL
  • NPI 1336197284
  NPD
• Melissa Shane Counseling Services LLC

  • Community/Behavioral Health Agency
  • Peoria, IL
  • NPI 1083125298
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1508902941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3318 W KING JAMES RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152564",
            "telephone_number": "309-202-0081",
            "fax_number": "309-693-8207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 N ORANGE PRAIRIE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159323",
            "telephone_number": "309-589-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGIZIO",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149011902",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149011902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia J Edwards, LCSW
• Elizabeth Eells, R.D. L.D.N
• Andrea Joy Eertmoed
• Alison B Eeten, CNP
• Marilyn S. Eeten, COTA
• Charles Egley, MD
• Peter Egwom, MD
• Prince Osazuwa Ehimamiegho, MD
• Alyssa Joann Ehnle, OTR/L
• Mikell Ryanne Ehnle, PSYD

• Clinical Social Worker in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.