Provider Demographics
NPI:1306238860
Name:FILLIMAN, TRISHA (APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:FILLIMAN
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 BEECH ST BLDG 10-6
Mailing Address - Street 2:
Mailing Address - City:NORMAL
Mailing Address - State:IL
Mailing Address - Zip Code:61761-1568
Mailing Address - Country:US
Mailing Address - Phone:309-245-7115
Mailing Address - Fax:309-204-8259
Practice Address - Street 1:1100 BEECH ST BLDG 10-6
Practice Address - Street 2:
Practice Address - City:NORMAL
Practice Address - State:IL
Practice Address - Zip Code:61761-1568
Practice Address - Country:US
Practice Address - Phone:309-245-7115
Practice Address - Fax:309-204-8259
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041417192163WP0808X
IL277003979363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health