Charles Fields, Lisa Ann

Charles Fields, Lisa Ann is an individual health care provider with primary practice located at 1809 Sheridan Rd , North Chicago IL 60064-2235. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Charles Fields, Lisa Ann can be contacted via phone (847) 785-0611.

Contact Information

Primary practice address
1809 Sheridan Rd North Chicago IL 60064-2235
Phone: (847) 785-0611
Fax: (847) 785-0612
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085.001395 Illinois

Profile Details

NPI number 1952313207
LBN Legal business name Charles Fields, Lisa Ann
Credentials PHD, PA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Nov 27th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952313207 NPPES
Illinois MEDICAID 085-001395

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