Mascioli, Lisa Marie
Mascioli, Lisa Marie is an individual health care provider with primary practice located at 385 Wirtz Dr , Dekalb IL 60115-3067. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Mascioli, Lisa Marie can be contacted via phone (815) 306-2777.Contact Information
Primary practice address
385 Wirtz Dr
Dekalb IL 60115-3067
Phone: (815) 306-2777
Fax: (815) 306-2778
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | APRN.CNP.019809 | Ohio |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 277002175 | Illinois |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 277002175 | Illinois |
Profile Details
NPI number | 1639627375 |
---|---|
LBN Legal business name | Mascioli, Lisa Marie |
Credentials | APRN, CNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 12th, 2016 |
Last updated | Feb 9th, 2024 - about 10 months 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 | 1639627375 | NPPES |
Ohio | MEDICAID | 2846675 |
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