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Contact Information

LISA M MAILLIARD
5841 S MARYLAND AVE
CHICAGO, IL60637-1443
 Phone: 888-824-0200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Gerontology

364SG0600X 89 Certified Clinical Nurse Specialist
Indicates primary specialty

NPI Profile & details for LISA M MAILLIARD · (Female)

NPI Number 1861514820
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2007
Last updated 10/24/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209000813
Hospital affiliation(s)
  • THE UNIVERSITY OF CHICAGO MEDICAL CENTER - (Acute Care)
    5841 SOUTH MARYLAND
    CHICAGO, IL 60637
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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