Individual
MRS. LISA E. SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 692-8110
(309) 692-8673
Mailing address
6501 N SHERIDAN RD, PEORIA, IL 61614-2932
(309) 692-8110
(309) 692-8673
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036-073903
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009033
HEALTH ALLIANCE PROVIDER
IL
05
—
036073903
—
IL
01
—
250004431
RAIL ROAD MEDICARE ID
IL
01
—
370681567-02
JOHN DEERE PROVIDER NUMBE
IL
Enumeration date
07/03/2006
Last updated
06/15/2010
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