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JEFFRY MARK TILLERY MD
NPI 1689602211
Family Medicine in Loves Park, IL

Active since June 30, 2006
9951 ROCK CUT XING, LOVES PARK, IL 61111(815) 639-8500(815) 639-8501 Get Directions Write a Review

NPPES record last updated: April 6, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jeffry Mark Tillery Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFRY MARK TILLERY MD (NPI 1689602211) is an individual family medicine provider in Loves Park, Illinois, licensed in Illinois (036078730) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1689602211
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJEFFRY MARK TILLERYCredential: MD
Location Address9951 ROCK CUT XINGLoves Park, IL 61111-1999
Mailing Address9951 Rock Cut XingLoves Park, IL 61111-1999 · (815) 639-8500 · Fax (815) 639-8501
Phone(815) 639-8500
Fax(815) 639-8501
Sole ProprietorNo
Enumeration DateJune 30, 2006
Last NPPES UpdateApril 6, 2009
✔ NPI 1689602211 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IL · 036078730
Definition
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.
9951 ROCK CUT XING, Loves Park, IL 61111
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Other Identifiers 10

Medicaid036078730IL
Other553180IL · Medicare Group #
Medicare ID-Type UnspecifiedL52862IL
Medicare PIN553180006IL
Medicare UPINE64513IL
Medicare ID-Type Unspecified834340IL · Medicare Group #
Medicare ID-Type Unspecified834370IL · Medicare Group #
Medicare ID-Type UnspecifiedCC5050IL · Rr Medicare Group #
Medicare ID-Type Unspecified080051087IL · Rr Individual #
Medicare ID-Type UnspecifiedL72082IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAINT ANTHONY MEDICAL CENTER
Home Health
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 381-6330
DR. MICHAEL DEMETRIOS KOUIMELIS MD
Family Medicine
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500
BRANDON N. NIERHOFF APN
Nurse Practitioner
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500
JESSICA KNOLL APN
Nurse Practitioner
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500
MICHAEL BERNARD MALONEY DO
Internal Medicine
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500
KIRSTEN AHLBERG
Social Worker (Clinical)
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500
MRS. KATHERINE I CARLSON PA-C
Physician Assistant
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8450
DR. NOAH JAMES SIMON M.D.
Family Medicine
9951 ROCK CUT XING
LOVES PARK, IL 61111
Winnebago County (815) 639-8500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jeffry Tillery's NPI number?

The NPI number for Jeffry Tillery is 1689602211. It was assigned to this individual provider in the NPPES registry on June 30, 2006.

Where is Jeffry Tillery located?

Jeffry Tillery practices at 9951 Rock Cut Xing, Loves Park, IL 61111. The listed phone number is (815) 639-8500.

What is Jeffry Tillery's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Jeffry Tillery was last updated on April 6, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.