Individual
LISETT ELIZABETH AVALOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3062 E 91ST ST, CHICAGO, IL 60617-4401
(773) 371-2900
Mailing address
4541 S LA CROSSE AVE, CHICAGO, IL 60638-1955
(312) 868-2579
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/10/2026
Last updated
07/10/2026
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