NPI 1205076874
Jeanne T de Lisle, PT
Practice location
- Address
- 718 N Greenwood Ave, Park Ridge, IL 60068-2508
- Phone
- (847) 708-7680
- Fax
- (847) 720-4335
Registered specialties
Specialist
Primary
Registry record
- NPI
- 1205076874
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 23 Feb 2009
- Record last updated
- 30 Aug 2010
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.