Provider Demographics
NPI:1497339253
Name:MILO, ELISE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:
Last Name:MILO
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 1:25219 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-7743
Mailing Address - Country:US
Mailing Address - Phone:708-710-6679
Mailing Address - Fax:
Practice Address - Street 1:7125 JANES AVE STE 300
Practice Address - Street 2:
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-2304
Practice Address - Country:US
Practice Address - Phone:630-981-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041453220163WM0102X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn