Individual
DR. LISA ANN DITCHEK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
241 GOLF MILL CENTER, STE 401, NILES, IL 60714
(847) 297-5380
(847) 480-9124
Mailing address
241 GOLF MILL CENTER, STE 401, NILES, IL 60714
(847) 297-5380
(847) 480-9124
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1622646
BCBS OF IL
IL
01
—
7495361
AETNA
IL
Enumeration date
03/23/2006
Last updated
07/08/2007
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