Individual
LISA RADVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
1747 W ROOSEVELT RD FL 5, CHICAGO, IL 60608-1264
(312) 226-3288
(312) 996-3848
Mailing address
435 N KENSINGTON AVE, LA GRANGE PARK, IL 60526-1873
(708) 209-0221
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209006073
IL
Other
Enumeration date
04/04/2007
Last updated
03/01/2012
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