Provider Demographics
NPI:1902462971
Name:PILIIN, MENA ROSE (APN)
Entity Type:Individual
Prefix:
First Name:MENA ROSE
Middle Name:
Last Name:PILIIN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 BARRINGTON RD
Mailing Address - Street 2:STE 501
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5020
Mailing Address - Country:US
Mailing Address - Phone:847-490-8900
Mailing Address - Fax:847-490-8901
Practice Address - Street 1:1585 BARRINGTON RD STE 501
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5020
Practice Address - Country:US
Practice Address - Phone:847-490-8900
Practice Address - Fax:847-490-8999
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2090194114363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209019414OtherIL APN LICENSE
IL264262528OtherTAX ID