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Individual

LISA B MESSINGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
650 DAKOTA ST STE A, CRYSTAL LAKE, IL 60012
(815) 455-6000
(815) 356-1104
Mailing address
650 DAKOTA ST STE A, CRYSTAL LAKE, IL 60012-3744
(815) 455-6000
(815) 356-1104

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-107027
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036107027
STATE LICENSE
IL
05
036107027
IL
Enumeration date
10/20/2006
Last updated
01/31/2019
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