Individual
MICHELLE LISZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 E 22ND ST, SUITE 201, LOMBARD, IL 60148-4976
(630) 627-4680
Mailing address
22W515 BALSAM DR, GLEN ELLYN, IL 60137-7355
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020011844
IL
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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