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1164544813
LISA RADVILLE
CHICAGO, IL
NPI
1164544813
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: IL 209006073)
Enumeration Date
2007-04-04
Last Update Date
2012-03-01
Business Address
-- LISA RADVILLE APN
1747 W ROOSEVELT RD FL 5
CHICAGO, IL 60608-1264
Phone number: 312-226-3288
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Mailing Address
-- LISA RADVILLE APN
435 N KENSINGTON AVE
LA GRANGE PARK, IL 60526-1873
Phone number: 708-209-0221
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