Provider Demographics
NPI:1114407582
Name:SILER, ABIGAIL M (RN)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:M
Last Name:SILER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 WILLOW TREE DR
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1974
Mailing Address - Country:US
Mailing Address - Phone:708-341-6846
Mailing Address - Fax:
Practice Address - Street 1:1403 ADAMS ST
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-1039
Practice Address - Country:US
Practice Address - Phone:847-458-9774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041462328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse