Healthcare Provider Details

I. General information

NPI: 1477781920
Provider Name (Legal Business Name): LISA M NEFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 12/14/2022
Certification Date: 12/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W SUPERIOR ST
CHICAGO IL
60622-5646
US

IV. Provider business mailing address

1230 YORK AVE ROCKEFELLER UNIVERSITY, BOX 179
NEW YORK NY
10065-6307
US

V. Phone/Fax

Practice location:
  • Phone: 312-666-3494
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RB0002X
TaxonomyObesity Medicine (Internal Medicine) Physician
License Number036.124164
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number036.124164
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: