Provider Demographics
NPI:1215193453
Name:WILLIAMS WILLIS, LORIAN LEIGH (APN/CNS)
Entity Type:Individual
Prefix:MS
First Name:LORIAN
Middle Name:LEIGH
Last Name:WILLIAMS WILLIS
Suffix:
Gender:F
Credentials:APN/CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 BORDEAUX CT
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2220
Mailing Address - Country:US
Mailing Address - Phone:708-684-1081
Mailing Address - Fax:708-684-4272
Practice Address - Street 1:4440 W 95TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2600
Practice Address - Country:US
Practice Address - Phone:708-684-1081
Practice Address - Fax:708-684-4272
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041298510163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn