IndividualActive
Elyse Fairand
NPI 1376214262 · Gerontology Nurse Practitioner · Maywood, IL
Provider details
- NPI number
- 1376214262
- Entity type
- Individual
- Primary specialty
- Gerontology Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 209024276 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
Phone: (312) 774-6297
Approximate (ZIP-level) locationGet directions
Mailing address
2160 S 1st Ave
Maywood, IL 60153-3328
Registry dates
- Enumerated
- 2021-09-22
- Last updated
- 2022-05-19
- Certified
- 2022-05-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.