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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 7 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639627375 NPPES
Ohio MEDICAID 2846675

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