Provider Demographics
NPI:1083441505
Name:ILIFF, LOIS
Entity type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:ILIFF
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 1:5112 STATE ROUTE 15
Mailing Address - Street 2:
Mailing Address - City:NEY
Mailing Address - State:OH
Mailing Address - Zip Code:43549-9715
Mailing Address - Country:US
Mailing Address - Phone:419-956-7854
Mailing Address - Fax:
Practice Address - Street 1:5112 STATE ROUTE 15
Practice Address - Street 2:
Practice Address - City:NEY
Practice Address - State:OH
Practice Address - Zip Code:43549-9715
Practice Address - Country:US
Practice Address - Phone:419-956-7854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker