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Contact Information

JESSICA K CARRILLO, DPM
3401 N BROAD ST
PHILADELPHIA, PA19140-5189
 Phone: 800-836-7536
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
 

Primary Podiatric Medicine

213EP1101X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JESSICA K CARRILLO · (Female)

NPI # 1508684697
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/28/2024
Last updated 06/23/2025 - About 12 months ago
Sole proprietor 1 No
Identifiers
  • PA License # SC007586
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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