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Individual

MS. LISA ANN CHARLES FIELDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, PA-C

Contact information

Practice address
1809 SHERIDAN RD, NORTH CHICAGO, IL 60064-2235
(847) 785-0611
(847) 785-0612
Mailing address
1809 SHERIDAN RD, NORTH CHICAGO, IL 60064-2235
(847) 785-0611
(847) 785-0612

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.001395
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
085-001395
IL
Enumeration date
08/13/2006
Last updated
11/27/2017
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