Individual
DR. LISA JEAN BURCKHARTZMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
228 NE JEFFERSON ST, PEORIA, IL 61602
(309) 671-8000
(309) 671-4695
Mailing address
2214 N UNIVERSITY ST, PEORIA, IL 61604
(309) 680-7634
(309) 676-5506
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036129370
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036129370
—
IL
Enumeration date
03/31/2008
Last updated
02/05/2016
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