Shaw, Lisa M

Shaw, Lisa M is an individual health care provider with primary practice located at 9729 N White Tail Trl , Stillman Valley IL 61084-9401. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Shaw, Lisa M can be contacted via phone (815) 218-1589.

Contact Information

Primary practice address
9729 N White Tail Trl Stillman Valley IL 61084-9401
Phone: (815) 218-1589
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 070.009273 Illinois

Profile Details

NPI number 1245453356
LBN Legal business name Shaw, Lisa M
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Jun 11th, 2012 - about 13 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 1245453356 NPPES
Illinois Other LS09920398P EARLY INTEVENTION NUMBER

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