Search › Illinois › 343900000X
Lisa Waldroup
NPI 1184188005 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1633 Tina Ln
Flossmoor, IL 60422 - Phone
- (708) 922-1344
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Also registered as
- 164W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-01-24
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