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1922798701
LISA MARIE FONTANINI
LONG GROVE, IL
NPI
1922798701
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 209.026950)
Enumeration Date
2023-05-15
Last Update Date
2023-05-15
Business Address
LISA MARIE FONTANINI
1226 MANASSAS LN
LONG GROVE, IL 60047-5085
Phone number: 773-457-3963
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Mailing Address
LISA MARIE FONTANINI
1226 MANASSAS LN
LONG GROVE, IL 60047-5085
Phone number: 773-457-3963
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