Jill Marie Talavera | Springfield, IL • PECOS Search

Jill Marie Talavera

Counselor

Behavioral Health & Social Service Providers

925 S Spring St Ste B, Springfield, IL 62704-2690

(217) 528-1988 (217) 971-3182

PECOS Enrollment

Based on the most recent information from CMS, provider Jill Marie Talavera does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1578876173
Provider Type
Individual
Full Name
Talavera, Jill Marie
Title
Mrs.
Credential
MA, LCPC, CADC

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/23/2010
Last Updated
7/23/2010

Contact Information

Practice Location

925 S Spring St Ste B, Springfield, IL 62704-2690

Unlisted Fax

Mailing Location

505 E Wineman St, Auburn, IL 62615-9728

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 178005539 Illinois