Individual
LISA M YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
2640 PATRIOT BLVD STE 100, GLENVIEW, IL 60026
(847) 510-6000
(847) 832-0905
Mailing address
2640 PATRIOT BLVD STE 100, GLENVIEW, IL 60026-8076
(847) 510-6000
(847) 832-0905
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046009798
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046009798
—
IL
Enumeration date
08/30/2005
Last updated
01/31/2024
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