Healthcare Provider Details

I. General information

NPI: 1306238860
Provider Name (Legal Business Name): TRISHA FILLIMAN APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2015
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 BEECH ST BLDG 10-6
NORMAL IL
61761-1568
US

IV. Provider business mailing address

1100 BEECH ST BLDG 10-6
NORMAL IL
61761-1568
US

V. Phone/Fax

Practice location:
  • Phone: 309-245-7115
  • Fax: 309-204-8259
Mailing address:
  • Phone: 309-245-7115
  • Fax: 309-204-8259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number041417192
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number277003979
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: