Individual
AMY LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP, RN
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
1864 FITCH CT, BATAVIA, IL 60510-8361
(630) 669-1558
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
041443651
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209024086
IL
Other
Enumeration date
08/24/2022
Last updated
08/24/2022
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