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1932743432
LISA KATHERINE FASONE
ROCKFORD, IL
NPI
1932743432
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085007338)
Enumeration Date
2019-10-29
Last Update Date
2019-10-29
Business Address
LISA KATHERINE FASONE PA-C
1502 PARKVIEW AVE
ROCKFORD, IL 61107-1821
Phone number: 815-381-7250
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Mailing Address
LISA KATHERINE FASONE PA-C
1502 PARKVIEW AVE
ROCKFORD, IL 61107-1821
Phone number: 815-381-7250
Copy
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