Individual
LISA M POLITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11603 25TH ST W, MILAN, IL 61264-4502
(309) 269-9396
(309) 787-6751
Mailing address
11603 25TH ST W, MILAN, IL 61264-4502
(309) 269-9396
(309) 787-6751
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
IL
Other
Enumeration date
07/05/2007
Last updated
07/10/2007
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