Healthcare Provider Details

I. General information

NPI: 1174087712
Provider Name (Legal Business Name): ELIZABETH THEODORA PRILLER MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH THEODORA CHAMBERS RN

II. Dates (important events)

Enumeration Date: 01/28/2019
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PARK CREST DR
FREEPORT IL
61032-3519
US

IV. Provider business mailing address

50 PARK CREST DR
FREEPORT IL
61032-3519
US

V. Phone/Fax

Practice location:
  • Phone: 815-291-8254
  • Fax:
Mailing address:
  • Phone: 815-291-8254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041363072
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: