Ingelse, Jill C

Ingelse, Jill C is an sole proprietor health care provider with primary practice located at 13114 Western Ave , Blue Island IL 60406-2439. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Ingelse, Jill C can be contacted via phone (708) 388-1228.

Contact Information

Primary practice address
13114 Western Ave Blue Island IL 60406-2439
Phone: (708) 388-1228
Fax: (708) 388-1696
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Pediatrics 152WP0200X 046009096 Illinois
Eye and Vision Services Providers / Optometrist 152W00000X 046009096 Illinois

Profile Details

NPI number 1528058443
LBN Legal business name Ingelse, Jill C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 22nd, 2005
Last updated Oct 20th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528058443 NPPES
Illinois MEDICAID 046009096
Illinois Other 1634291

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