Individual
LISET GARCIA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1919 W TAYLOR ST # MC663, CHICAGO, IL 60612-7246
(312) 996-2933
Mailing address
1919 W TAYLOR ST # MC663, CHICAGO, IL 60612-7246
(312) 996-2933
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125.086264
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
03/27/2025
Last updated
06/11/2025
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