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:
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Health care specialties

SpecialtyCodeLicense #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 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134114804 NPPES
Iowa MEDICAID 0162610
Iowa Other 41636

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