Individual
LISA HESWALL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2101 WAUKEGAN RD, SUITE 110, BANNOCKBURN, IL 60015-1836
(847) 914-0544
Mailing address
8930 WAUKEGAN RD, SUITE 200 - ATTN: RAQUEL LEON, MORTON GROVE, IL 60053-2126
(847) 324-3976
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
05/27/2006
Last updated
07/08/2007
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