MISS JILL C HEADRICK (NPI# 1972967016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972967016 |
| Entity Type | Individual |
| Full Name | MISS JILL C HEADRICK |
| Practice Address |
500 E Lake Shore Dr Decatur IL 62521-3336 |
| Practice Telephone | 2174752234 |
| Mailing Telephone | 2174752234 |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2016-04-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 222Q00000X | Developmental Therapist | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
500 E LAKE SHORE DR |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497877237 | Debra Widehofer | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2007-04-04 |
| 1861968307 | Maria Ann Goad | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2018-10-23 |
| 1790084770 | Jodi Lynne Folmnsbee | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2011-03-16 |
| 1124140983 | Dena Cearlock | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2007-04-04 |
| 1942322714 | Diane Dunn | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2007-04-04 |
| 1538281191 | Krista Gerhardt | Developmental Therapist | 500 E Lake Shore Dr, Decatur, IL 62521-3336 | 2007-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 222Q00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Developmental Therapist |
| A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Developmental Therapy Association. A developmental therapist evaluates children's global development in order to identify areas of developmental delay whether arising from physiological, neurological, or environmental factors, or a combination of factors; and designs, implements, and modifies therapeutic interventions for the child and the family to promote the child's acquisition of skills in a variety of developmental areas, including cognitive processes and social interaction in order to maximize functional independence and developmental homeostasis, and improve the quality of life at home and in the community; and provides consultation for the parents and other professionals working with the family on global development. |
| Notes: Source: The Illinois Developmental Therapists Association [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124642111 | Sharon M Renfro | Developmental Therapist | 118 Greenridge Dr, Decatur, IL 62526-1426 | 2020-06-04 |
| 1912553538 | Taylor Patterson | Developmental Therapist | 2237 Appletree Ln, Decatur, IL 62521-3901 | 2019-08-11 |
| 1457903056 | Jenna Mccrady | Developmental Therapist | 4524 Havenwood Dr, Decatur, IL 62526-1125 | 2019-07-12 |
| 1861057739 | Amy Lizette Porter | Developmental Therapist | 1070 W Olive St, Decatur, IL 62526-3761 | 2019-05-07 |
| 1528545274 | Julia Catherine Moroney | Developmental Therapist | 3279 Fields Ct, Decatur, IL 62521-4814 | 2018-07-25 |
| 1720471998 | Shawn Sanders | Developmental Therapist | 3858 N Camelot Dr, Apt 3b, Decatur, IL 62526-2057 | 2015-03-12 |
| 1073905030 | Elizabeth Ann Harding | Developmental Therapist | 1045 E Harrison Ave, Decatur, IL 62526-4872 | 2015-02-28 |
| 1255747820 | Kristy Young | Developmental Therapist | 340 Olympic Ct, Apt 17, Decatur, IL 62526-1811 | 2014-07-03 |
| 1699116913 | Carrie Casch | Developmental Therapist | 2266 S Franzy Dr, Decatur, IL 62521-5577 | 2013-07-15 |
| 1295063881 | Courtney Dyan Kirk | Developmental Therapist | 4815 N Martin Luther King Jr Dr, Apt 112, Decatur, IL 62526-6127 | 2009-11-20 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.