Individual
DIANE LILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
675 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 257-9400
Mailing address
1265 JOHN Q HAMMONS DR, MADISON, WI 53717-1941
(608) 257-3842
(608) 257-3842
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2266
WI
Other
Enumeration date
07/14/2006
Last updated
07/08/2007
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