Provider Demographics
NPI:1821390667
Name:RUBIO, LILIANA (APN, MSN)
Entity Type:Individual
Prefix:
First Name:LILIANA
Middle Name:
Last Name:RUBIO
Suffix:
Gender:F
Credentials:APN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2640 S SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60623-4415
Mailing Address - Country:US
Mailing Address - Phone:773-762-5194
Mailing Address - Fax:
Practice Address - Street 1:2045 W WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-2428
Practice Address - Country:US
Practice Address - Phone:312-413-7935
Practice Address - Fax:312-413-7938
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.0084878363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily