Individual
TERESITA MISMANOS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
224 CLARENDON DR., ROUND LAKE BEACH, IL 60073
(847) 984-5100
Mailing address
20 W STONE AVE, LAKE FOREST, IL 60045-2959
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
IL
Other
Enumeration date
12/14/2005
Last updated
07/08/2007
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