Provider Demographics
NPI:1629325469
Name:BRILL, CINDY ELIZABETH (LPN NHA)
Entity Type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:ELIZABETH
Last Name:BRILL
Suffix:
Gender:F
Credentials:LPN NHA
Other - Prefix:MRS
Other - First Name:CINDY
Other - Middle Name:ELIZABETH
Other - Last Name:SEARS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1504 12TH ST
Mailing Address - Street 2:
Mailing Address - City:SILVIS
Mailing Address - State:IL
Mailing Address - Zip Code:61282-2057
Mailing Address - Country:US
Mailing Address - Phone:309-644-1482
Mailing Address - Fax:
Practice Address - Street 1:1504 12TH ST
Practice Address - Street 2:
Practice Address - City:SILVIS
Practice Address - State:IL
Practice Address - Zip Code:61282-2057
Practice Address - Country:US
Practice Address - Phone:309-644-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2012-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAP43188164W00000X
IL044.006373164W00000X
IL164W00000X164W00000X
IA164W00000X164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse