Individual
M. LISA YAREMKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
355 RIDGE AVE, EVANSTON, IL 60202-3328
(847) 316-2284
(847) 316-2943
Mailing address
925 MAPLE AVE, EVANSTON, IL 60202-1717
(847) 328-3938
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036072184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036072184
—
IL
Enumeration date
09/02/2005
Last updated
07/17/2014
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