Individual
DR. LISA MEDALIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, CBSM
Contact information
Practice address
1101 DAVIS ST, EVANSTON, IL 60201-5945
(773) 702-6169
Mailing address
1101 DAVIS ST STE 5767, EVANSTON, IL 60201-5945
(844) 475-3379
(855) 644-2981
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071.008089
IL
Other
Enumeration date
03/15/2011
Last updated
03/29/2024
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