Individual
DR. LISA MARIE SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1525 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2260
(618) 943-4949
(618) 943-5858
Mailing address
1525 LEXINGTON AVE, LAWRENCEVILLE, IL 62439-2260
(618) 943-4949
(618) 943-5858
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038-010120
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05132005
BLUE CROSS BLUE SHEILDPIN
IL
01
—
660547
HEALTHLINK PIN
IL
01
—
900141448
FEIN
IL
Enumeration date
04/27/2006
Last updated
01/11/2012
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