Individual
LISA PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, HTL(ASCP)
Contact information
Practice address
1611 SIMMS ST, AURORA, IL 60504-4359
(708) 368-5055
Mailing address
1611 SIMMS ST, AURORA, IL 60504-4359
(708) 368-5055
Taxonomy
Speciality
Code
Description
License number
State
246QH0600X
Histology Specialist/Technologist
—
—
246QL0900X
Laboratory Management Specialist/Technologist
Primary
—
—
376K00000X
Nurse's Aide
—
IL
Other
Enumeration date
10/09/2020
Last updated
12/27/2022
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