Individual
LISA WADSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 SUMMIT DR, LOCKPORT, IL 60441-3392
(815) 836-0500
(815) 725-7500
Mailing address
114 MORRIS ST, JOLIET, IL 60436-1229
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
IL
Other
Enumeration date
02/21/2007
Last updated
07/08/2007
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