Provider Demographics
NPI:1235851890
Name:ALLEN, LILIAN A (PH D, DNP)
Entity Type:Individual
Prefix:DR
First Name:LILIAN
Middle Name:A
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PH D, DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18409 DARTRY DR
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-5295
Mailing Address - Country:US
Mailing Address - Phone:773-803-3288
Mailing Address - Fax:
Practice Address - Street 1:18409 DARTRY DR
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-5295
Practice Address - Country:US
Practice Address - Phone:773-803-3288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209025925363L00000X
CA95022467363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner