Individual
LISA EVERTSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1225 W LAKE ST, MELROSE PARK, IL 60160
(708) 681-3000
(708) 938-7179
Mailing address
840 BONITA AVE, ELK GROVE VILLAGE, IL 60007-4410
(847) 494-5566
(847) 364-5566
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.005350
IL
Other
Enumeration date
01/29/2015
Last updated
09/03/2018
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