Provider Demographics
NPI:1619165750
Name:SCHILLER, ALISSA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:M
Last Name:SCHILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 N HALSTED ST STE 405
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-8480
Mailing Address - Country:US
Mailing Address - Phone:773-296-7300
Mailing Address - Fax:773-296-7390
Practice Address - Street 1:3000 N HALSTED ST STE 405
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-296-7300
Practice Address - Fax:773-296-7390
Is Sole Proprietor?:No
Enumeration Date:2007-10-12
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085005193363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAJ209ZOtherMEDICARE
FL293000500Medicaid