| Doctor Name: | MRS. JILL WIDIKER |
| NPI Number: | 1598938714 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, CCC-SLP |
| License Number: | 2622-154 |
| Business Practice Address: | 18601 Lincoln St Whitehall, WI - 547738605 |
| Business Phone Number: | 7155384361 |
| Business Fax Number: | 7155381700 |
| Mailing Address: | 410 E Pine St, STRUM |
| State: | WI |
| Postal Code: | 547707868 |
| Phone Number: | 7156953349 |
| Fax Number: | |
| NPI Enumeration Date: | 04/09/2008 |
| NPI Last Update Date: | 04/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2622-154 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |