Lis, Susan
Lis, Susan is an individual health care provider with primary practice located at 1775 Ballard Rd Nesset Pavilion, Park Ridge IL 60068-1005. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Lis, Susan can be contacted via phone (847) 318-2500.Contact Information
Primary practice address
1775 Ballard Rd Nesset Pavilion
Park Ridge IL 60068-1005
Phone: (847) 318-2500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 036078743 | Illinois |
Profile Details
| NPI number | 1407882848 |
|---|---|
| LBN Legal business name | Lis, Susan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 25th, 2006 |
| Last updated | Dec 17th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407882848 | NPPES |
| Illinois | MEDICAID | 036078743 |
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