Individual
LIZAMMA MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1901-WEST-HARRISON STREET, CHICAGO, IL 60612
(312) 864-6000
(312) 864-9765
Mailing address
1685 HOLLY AVE, NORTHBROOK, IL 60062-5021
(312) 864-3400
(312) 864-9765
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209-004591
IL
Other
Enumeration date
10/31/2006
Last updated
04/27/2021
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