Provider Demographics
NPI:1295947331
Name:WILLIAMS, LISA MARIE (RN, MS, AACRN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:WILLIAMS
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Gender:F
Credentials:RN, MS, AACRN
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Mailing Address - Street 1:1509 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-4526
Mailing Address - Country:US
Mailing Address - Phone:630-963-7958
Mailing Address - Fax:312-926-9630
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:GALTER PAVILION, SUITE 13-205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-4114
Practice Address - Fax:312-926-9630
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist