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Individual

DR. LISA G WOHL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
303 E ARMY TRAIL RD, SUITE 200, BLOOMINGDALE, IL 60108-2169
(630) 351-2030
(630) 351-3983
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
36060734
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02215680
BLUE CROSS BLUE SHIELD
IL
05
036060734
IL
01
049603001
DMERC
IL
01
180012516
RAILROAD MEDICARE
IL
Enumeration date
06/20/2006
Last updated
08/29/2023
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