Individual
LISA M DE ZOUTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
675 N SAINT CLAIR ST STE 19-100, CHICAGO, IL 60611-5969
(312) 664-3278
(312) 695-5774
Mailing address
675 N SAINT CLAIR ST STE 19-100, CHICAGO, IL 60611-5969
(312) 664-3278
(312) 695-5774
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209012809
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209012809
IL
Other
Enumeration date
06/02/2015
Last updated
05/04/2022
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