Individual
LIJI SURRAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1969 W OGDEN AVE, CHICAGO, IL 60612-3765
(312) 864-6000
Mailing address
2276 PEBBLESTONE WAY, BOLINGBROOK, IL 60490-5061
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-026588
IL
Other
Enumeration date
01/24/2023
Last updated
10/10/2023
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