Individual
THEATRICE LANCASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPT
Contact information
Practice address
464 MALLVIEW LN, BOLINGBROOK, IL 60440-2908
(630) 607-4349
(888) 453-5119
Mailing address
464 MALLVIEW LN, BOLINGBROOK, IL 60440-2908
(630) 607-4349
(888) 453-5119
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
24F-1942
IL
Other
Enumeration date
05/07/2025
Last updated
05/07/2025
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