Liesveld, Jill L
Liesveld, Jill L is an individual health care provider with primary practice located at 200 Hawkins Dr , Iowa City IA 52242-1009. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Addiction Psychiatry is her primary health care specialty. Liesveld, Jill L can be contacted via phone (319) 384-9364.Contact Information
Primary practice address
200 Hawkins Dr
Iowa City IA 52242-1009
Phone: (319) 384-9364
Fax: (319) 384-9362
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 26197 | Iowa |
Allopathic & Osteopathic Physicians / Addiction Psychiatry | 2084P0802X | 26197 | Iowa |
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 26197 | Iowa |
Profile Details
NPI number | 1134114804 |
---|---|
LBN Legal business name | Liesveld, Jill L |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 19th, 2005 |
Last updated | Dec 12th, 2007 - about 18 years ago |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1134114804 | NPPES |
Iowa | MEDICAID | 0162610 | |
Iowa | Other | 41636 |
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