MEDICARE: LILLIAN S OBERLANDER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	209.025131	IL

General Provider Information

NPI Number	:	1962147629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILLIAN S OBERLANDER

Provider Business Mailing Address
First Line	:	1645 W JACKSON BLVD STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2847
Country	:	US
Telephone Number	:	312-563-6637
Fax Number	:

Provider Business Practice Location Address
First Line	:	1645 W JACKSON BLVD STE 600
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-2847
Country	:	US
Telephone Number	:	312-563-6637
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2022
Last Update Date	:	02/06/2023

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Directions to “ LILLIAN S OBERLANDER ” Practice Location

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