Fantroy, Lisa M.

Fantroy, Lisa M. is an individual health care provider with primary practice located at 4001 Vollmer Rd. , Olympia Fields IL 60461. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Fantroy, Lisa M. can be contacted via phone (708) 481-8883.

Contact Information

Primary practice address
4001 Vollmer Rd. Olympia Fields IL 60461
Phone: (708) 481-8883
Fax: (708) 481-2917
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085001107 Illinois

Profile Details

NPI number 1982799508
LBN Legal business name Fantroy, Lisa M.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Mar 18th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982799508 NPPES
Illinois Other IL5686021 MEDICARE PTAN

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