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Individual

MS. LISA MERLE PECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
350 S WAUKEGAN RD STE 100&200, DEERFIELD, IL 60015-5239
(847) 535-7157
(224) 271-4332
Mailing address
3220 W IL ROUTE 60, MUNDELEIN, IL 60060
(847) 837-8442
(847) 837-8542

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-086705
IL
207R00000X
Internal Medicine Physician
Primary
036086705
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036-086705
IL
05
036086705
IL
Enumeration date
04/21/2006
Last updated
09/11/2023
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