Individual
DR. LISA K WRIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 339-3583
Mailing address
31 W 155TH ST, HARVEY, IL 60426-3556
(708) 596-5177
(708) 339-3583
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036087134
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087134
—
IL
01
—
1634171
BCBSIL GROUP NUMBER
—
Enumeration date
07/28/2005
Last updated
12/28/2011
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