Individual
DR. SUSAN D LIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1775 BALLARD RD, NESSET PAVILION, PARK RIDGE, IL 60068-1005
(847) 318-2500
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036078743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036078743
—
IL
Enumeration date
06/25/2006
Last updated
04/15/2025
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