Individual
DR. MARIE-LESLY EMMANUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2490 CENTRAL AVE, LAKE STATION, IN 46405-2122
(210) 358-3888
Mailing address
1889 W WINDSOR DR, ROUND LAKE, IL 60073-9709
(224) 308-4614
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01094805A
IN
Other
Enumeration date
04/08/2021
Last updated
10/24/2024
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