IndividualActive
Lisa Mailliard
NPI 1861514820 · Gerontology Clinical Nurse Specialist · Chicago, IL
Provider details
- NPI number
- 1861514820
- Entity type
- Individual
- Primary specialty
- Gerontology Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 209000813 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
5841 S Maryland Ave
Chicago, IL 60637-1443
Phone: (888) 824-0200
Approximate (ZIP-level) locationGet directions
Mailing address
150 Harvester Dr
Burr Ridge, IL 60527-5919
Registry dates
- Enumerated
- 2007-04-03
- Last updated
- 2022-10-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.