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1528079803
LARA M. ELLISON
NAPERVILLE, IL
NPI
1528079803
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036114549)
Enumeration Date
2006-08-11
Last Update Date
2021-03-26
Business Address
LARA M. ELLISON D.O.
2007 95TH STREET SUITE 105
NAPERVILLE, IL 60563-7802
Phone number: 630-646-6920
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Mailing Address
LARA M. ELLISON D.O.
2007 95TH ST STE 105
NAPERVILLE, IL 60563-7802
Phone number: 630-646-6920
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