Individual
LISA MARIE VIVACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
850 E GOLF RD, SCHAUMBURG, IL 60173-4502
(847) 519-1020
Mailing address
1360 CUMBERLAND CIR W, ELK GROVE VILLAGE, IL 60007-3806
(224) 616-8920
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.011633
IL
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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