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General NPI Number Information
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NPI Number | 1932713435
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Entity Type | Individual
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Provider Name | LORI SUE TRILIKIS APRN
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 7317 N WILLOW LAKE CT
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City | PEORIA
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State | IL
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Zip | 61614-8227
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Country | US
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Telephone | 309-683-7373
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Fax |
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Provider Business Mailing Address
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Address Line | 5615 N MONTELLO DR
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City | PEORIA
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State | IL
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Zip | 61614-3934
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Country | US
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Telephone | 309-360-3922
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 209021883
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License Number State | IL
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