Individual
LISA STEPHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4735 WILLOW SPRINGS RD, LA GRANGE, IL 60525-6130
(708) 698-5259
Mailing address
7144 S PAULINA ST, CHICAGO, IL 60636-3823
(773) 776-8759
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.009515
IL
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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