Individual
LILLIE RIZACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
34TH AND CIVIC CENTER BLVD, THE CHILDREN'S HOSPITAL OF PHILADELPHIA, PHILADELPHIA, PA 19104
(267) 425-6900
Mailing address
6938 WEATHAM ST, PHILADELPHIA, PA 19119-2519
(267) 471-1315
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
MW008589L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001814185
—
PA
Enumeration date
12/21/2005
Last updated
12/22/2014
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