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General NPI Number Information
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NPI Number | 1306617972
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Entity Type | Individual
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Provider Name | LISA D PARISI-REILLY NURSE PRACTIONER
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/12/2024
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Provider Practice Location Address
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Address Line | 7435 W TALCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3707
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Country | US
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Telephone | 773-990-8498
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Fax |
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Provider Business Mailing Address
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Address Line | 1330 S CHESTER AVE
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City | PARK RIDGE
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State | IL
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Zip | 60068-5106
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Country | US
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Telephone | 312-505-1935
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.025123
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 163WW0000X
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Taxonomy Name | Wound Care Registered Nurse
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License Number | 041.306967
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License Number State | IL
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