LISA TAMAR PROVORNY

CHICAGO, IL
NPI1518354331
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101Y00000X Counselor
(Licence: IL  180011361)
Enumeration Date2015-04-20
Last Update Date2022-05-20
Business Address
LISA TAMAR PROVORNY L.C.P.C.
3320 W FOSTER AVE # 124
CHICAGO, IL 60625-4813
Phone number: 773-645-1443
Mailing Address
LISA TAMAR PROVORNY L.C.P.C.
3320 W FOSTER AVE # 124
CHICAGO, IL 60625-4813
Phone number: 773-645-1443