Provider Demographics
NPI:1558766139
Name:MILLAS, LEE-ANNE J (APN, FNP-C)
Entity Type:Individual
Prefix:
First Name:LEE-ANNE
Middle Name:J
Last Name:MILLAS
Suffix:
Gender:F
Credentials:APN, FNP-C
Other - Prefix:
Other - First Name:LEE-ANNE
Other - Middle Name:J
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C, FNP-BC
Mailing Address - Street 1:14449 KEELER AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:IL
Mailing Address - Zip Code:60445-2722
Mailing Address - Country:US
Mailing Address - Phone:708-238-5417
Mailing Address - Fax:
Practice Address - Street 1:1441 BRANDING AVE
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1160
Practice Address - Country:US
Practice Address - Phone:773-413-3893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-25
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041371891163W00000X
IL209011796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse