Individual
LISA A BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611
(312) 227-6090
(312) 227-9403
Mailing address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(800) 543-7362
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.008268
IL
Other
Enumeration date
09/09/2010
Last updated
12/19/2025
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