Moran, Lisa M

Moran, Lisa M is an individual health care provider with primary practice located at 360 Station Dr Ste 120 , Crystal Lake IL 60014-7994. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Moran, Lisa M can be contacted via phone (815) 477-8900.

Contact Information

Primary practice address
360 Station Dr Ste 120 Crystal Lake IL 60014-7994
Phone: (815) 477-8900
Fax: (815) 477-7160
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209015062 Illinois

Profile Details

NPI number 1992252399
LBN Legal business name Moran, Lisa M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2016
Last updated Sep 1st, 2020 - about 4 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 1992252399 NPPES
Illinois Other 209015062 STATE LICENSE

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