Provider Demographics
NPI:1669836896
Name:ILYASH, LYUDMYLA (FNP-C)
Entity Type:Individual
Prefix:
First Name:LYUDMYLA
Middle Name:
Last Name:ILYASH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 W FOREST PRESERVE DR
Mailing Address - Street 2:APT 309
Mailing Address - City:NORRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60706-1372
Mailing Address - Country:US
Mailing Address - Phone:773-756-7496
Mailing Address - Fax:
Practice Address - Street 1:1441 BRANDING AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1160
Practice Address - Country:US
Practice Address - Phone:773-756-7496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013485363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily