Individual
LISA ANN SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6415 ELM ST APT 4B, MORTON GROVE, IL 60053-2640
(847) 331-1880
Mailing address
6415 ELM ST APT 4B, MORTON GROVE, IL 60053-2640
(847) 331-1880
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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