Provider Demographics
NPI:1386511517
Name:KIZER, DEIARA LASHAE (RN-BSN)
Entity type:Individual
Prefix:MS
First Name:DEIARA
Middle Name:LASHAE
Last Name:KIZER
Suffix:
Gender:F
Credentials:RN-BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W 74TH ST UNIT 2
Mailing Address - Street 2:UNIT G
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60621-3403
Mailing Address - Country:US
Mailing Address - Phone:630-881-7583
Mailing Address - Fax:
Practice Address - Street 1:107 W 74TH ST UNIT G
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60621-3403
Practice Address - Country:US
Practice Address - Phone:630-881-7583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041484642163WC1600X, 163WN1003X, 163WS0200X, 163WW0101X, 163WC1500X
IL0410484642163WH1000X, 1744R1103X, 171M00000X, 174H00000X, 172V00000X, 1744R1102X, 251E00000X, 251G00000X, 251K00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker
No1744R1102XOther Service ProvidersSpecialistResearch Study
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health