Individual
LISA F DERKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 FOX GLEN DR, BARRINGTON, IL 60010-1824
(847) 382-9150
(847) 382-9155
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036095963
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095963
—
IL
Enumeration date
10/13/2005
Last updated
03/26/2025
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