Medalie, Lisa

Medalie, Lisa is an sole proprietor health care provider with primary practice located at 1101 Davis St , Evanston IL 60201-5945. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as her primary health care specialty. Medalie, Lisa can be contacted via phone (773) 702-6169.

Contact Information

Primary practice address
1101 Davis St Evanston IL 60201-5945
Phone: (773) 702-6169
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 071.008089 Illinois

Profile Details

NPI number 1609175744
LBN Legal business name Medalie, Lisa
Credentials PSYD, CBSM
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 15th, 2011
Last updated Mar 29th, 2024 - about last year

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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