Individual
LAUREN RISSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-5313
(847) 723-2325
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
(847) 390-5900
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
A147062
CA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
036.146133
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790222529
—
CA
Enumeration date
01/31/2017
Last updated
08/23/2022
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