Individual
DR. LISA P SOLOMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2202 HARLEM RD, SUITE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Mailing address
2202 HARLEM RD, SUITE 200, LOVES PARK, IL 61111-2754
(815) 877-4848
(815) 654-5342
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.126428
IL
207L00000X
Anesthesiology Physician
125054302
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036126428
—
IL
01
—
125054302
MEDICAL TEMPORARY LICENSE
IL
Enumeration date
07/23/2008
Last updated
12/20/2013
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