Individual
LORI GILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
837 E. CEDAR ST., STE 100, SOUTH BEND, IN 46617
(574) 237-7338
(574) 237-7881
Mailing address
837 E. CEDAR ST., STE 100, SOUTH BEND, IN 46617
(574) 237-7338
(574) 237-7881
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
28096015A
IN
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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