Individual
LISA MARIE OLDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7447 W TALCOTT AVE STE 454, CHICAGO, IL 60631-3715
(773) 631-5767
Mailing address
7447 W TALCOTT AVE STE 454, CHICAGO, IL 60631-3715
(773) 631-5767
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
036-105494
IL
Other
Enumeration date
04/03/2006
Last updated
10/04/2021
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