Provider Demographics
NPI:1932444130
Name:NDU, LILLIAN CHIME
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:CHIME
Last Name:NDU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 W RIVERS EDGE CIR
Mailing Address - Street 2:APT # 116
Mailing Address - City:BROWN DEER
Mailing Address - State:WI
Mailing Address - Zip Code:53209-1131
Mailing Address - Country:US
Mailing Address - Phone:414-393-8540
Mailing Address - Fax:
Practice Address - Street 1:4121 W RIVERS EDGE CIR
Practice Address - Street 2:APT # 116
Practice Address - City:BROWN DEER
Practice Address - State:WI
Practice Address - Zip Code:53209-1131
Practice Address - Country:US
Practice Address - Phone:414-393-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI309786-31164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse