Individual
LIVIA DE SOUZA LISBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
2650 WARRENVILLE RD STE 280, DOWNERS GROVE, IL 60515-2075
(630) 324-7900
Mailing address
2650 WARRENVILLE RD STE 280, DOWNERS GROVE, IL 60515-2075
(630) 324-7900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006328
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085006328
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
IL
01
—
1144532
NCCPA
IL
Enumeration date
08/28/2017
Last updated
09/12/2025
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