JEFFRY MARK TILLERY MD NPI 1689602211

NPI Information

  • NPI: 1689602211
  • Provider Name: JEFFRY MARK TILLERY, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 9951 ROCK CUT XING
    LOVES PARK, IL
    ZIP 61111
  • Phone: (815) 639-8500

Map and Directions

Get Directions

NPI Details

Jeffry Mark Tillery, MD is a family medicine in Loves Park, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Jeffry Mark Tillery, MD NPI is 1689602211. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

9951 ROCK CUT XING
LOVES PARK, IL
ZIP 61111-999
Phone: (815) 639-8500
Fax: (815) 639-8501

The NPI 1689602211 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 6/30/2006 and was last updated on 4/6/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine036078730ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1036078730MEDICAIDILLINOIS
2553180OTHERILLINOISMEDICARE GROUP #
3L52862MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
4553180006MEDICARE PINILLINOIS
5E64513MEDICARE UPINILLINOIS
6834340MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP #
7834370MEDICARE ID-TYPE UNSPECIFIEDILLINOISMEDICARE GROUP #
8CC5050MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR MEDICARE GROUP #
9080051087MEDICARE ID-TYPE UNSPECIFIEDILLINOISRR INDIVIDUAL #
10L72082MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI