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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407882848 NPPES
Illinois MEDICAID 036078743

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