Healthcare Provider Details

I. General information

NPI: 1558903237
Provider Name (Legal Business Name): CLAIRE CHRISTINE CHIRILLO MSN, AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD
ROYAL OAK MI
48073-6770
US

IV. Provider business mailing address

4660 S HAGADORN RD STE 315
EAST LANSING MI
48823-5353
US

V. Phone/Fax

Practice location:
  • Phone: 248-288-9340
  • Fax:
Mailing address:
  • Phone: 517-351-8377
  • Fax: 517-351-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4704284947
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704284947
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: