Individual
DR. LISA ANN RAVINDRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
610 S MAPLE AVE, OAK PARK, IL 60304-1091
(708) 660-2240
Mailing address
610 S MAPLE AVE, OAK PARK, IL 60304-1091
(708) 660-2240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125058865
IL
207R00000X
Internal Medicine Physician
Primary
36133449
IL
207R00000X
Internal Medicine Physician
57.020553
OH
Other
Enumeration date
07/10/2010
Last updated
10/08/2013
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