SearchIllinois1710I1002X

Clinton Lariscy, IDC

NPI 1164736302 · on the registry since 2010 · sole proprietor

Practice

Address
3355 Illinois St
Recruit Training Command Great Lakes
Great Lakes, IL 60088
Phone
(847) 688-4643
Clinicians at this address
2

Registry record

Primary taxonomy
1710I1002X
1710I1002X
Sex
Male
Record last updated
2010-07-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois