Individual
CAROLYN LIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
633 W OAKDALE AVE # 4E, CHICAGO, IL 60657-5358
(847) 922-5939
Mailing address
633 W OAKDALE AVE # 4E, CHICAGO, IL 60657-5358
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86377545
IL
Other
Enumeration date
12/04/2023
Last updated
12/04/2023
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