Provider Demographics
NPI:1538330568
Name:PIPER, MICHELLE E (CNM, APN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:E
Last Name:PIPER
Suffix:
Gender:F
Credentials:CNM, APN
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:E
Other - Last Name:LISANTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM, APN
Mailing Address - Street 1:1300 E WOODFIELD RD STE 308
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173
Mailing Address - Country:US
Mailing Address - Phone:847-485-2650
Mailing Address - Fax:847-221-4896
Practice Address - Street 1:1300 E WOODFIELD RD STE 308
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-485-2650
Practice Address - Fax:847-221-4896
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209004963367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife