Individual provider Active NPI

Jill Suzanne Hartwig, BA CADC

  • Addiction (Substance Use Disorder) Counselor
  • Rockford, IL
National Provider Identifier
1720121973
Registry record updated Aug 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
2704 N Main St
Rockford, IL 61103
Phone
(815) 968-9300
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

2704 N Main St
Rockford, IL 61103

Mailing address

5035 Linden Rd
Rockford, IL 61109-5840
Phone (815) 560-2399

Other practice location 1

125 S 4th St
Oregon, IL 61061-1609
Phone (815) 732-3157

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
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1720121973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 LINDEN RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611095840",
            "telephone_number": "815-560-2399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2704 N MAIN ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61103",
            "telephone_number": "815-968-9300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "IL",
            "postal_code": "610611609",
            "country_code": "US",
            "telephone_number": "815-732-3157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTWIG",
        "first_name": "JILL",
        "middle_name": "SUZANNE",
        "credential": "BA CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.