Micetich, Lisa Marie

Micetich, Lisa Marie is an sole proprietor health care provider with primary practice located at 2800 W 95Th St , Evergreen Park IL 60805-2701. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Micetich, Lisa Marie can be contacted via phone (708) 229-5429.

Contact Information

Primary practice address
2800 W 95Th St Evergreen Park IL 60805-2701
Phone: (708) 229-5429
Fax: (708) 229-5308
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X Illinois

Profile Details

NPI number 1568682284
LBN Legal business name Micetich, Lisa Marie
Credentials Registered Dietitian (RD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2007
Last updated Jul 8th, 2007 - about 17 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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