GILLIS PSYCHIATRY LLC NPI 1578428116

NPI Information

  • NPI: 1578428116
  • Provider Name: GILLIS PSYCHIATRY LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 17434 STATE ROAD 23
    SOUTH BEND, IN
    ZIP 46635
  • Phone: (574) 272-6406

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NPI Details

GILLIS PSYCHIATRY LLC is a psychiatric/mental health nurse practitioner in South Bend, IN. GILLIS PSYCHIATRY LLC NPI is 1578428116. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17434 STATE ROAD 23
SOUTH BEND, IN
ZIP 46635-743
Phone: (574) 272-6406
Fax: (464) 333-9684

The provider's authorized official is Lucinda Kil Gillis .
The authorized official title is Managing Member and has the following contact phone number (574) 329-0241.

The enumeration date for this NPI number is 12/17/2025 and was last updated on 12/30/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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