Dr. Lisa Marie Villanueva, M.D.
Pediatrics in Park Ridge, IL. Individual provider (NPI-1).
NPI number1972513331
StatusActive
Last updated in NPPESDec 17, 2021
Details
- NPI
- 1972513331
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lisa Marie Villanueva
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 9, 2006
- Certification date
- Dec 17, 2021
- Last updated
- Dec 17, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 036-093553 | IL | Yes |
Practice location
101 S Washington AveSuite 122
Park Ridge, IL 60068-4200
Phone 847-692-6628 · Fax 847-692-6891
Mailing address
101 S Washington AveSuite 122
Park Ridge, IL 60068-4200
Phone 847-692-6628 · Fax 847-692-6891
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