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General NPI Number Information
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NPI Number | 1023718723
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Entity Type | Individual
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Provider Name | LISA MARIE PRANGER PSY.D., H.S.P.P.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 7777 W LINCOLN HWY STE A
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City | FRANKFORT
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State | IL
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Zip | 60423-9491
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Country | US
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Telephone | 815-446-1272
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Fax | 815-935-1091
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Provider Business Mailing Address
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Address Line | 3031 CHIPPEWA DR
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City | BOURBONNAIS
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State | IL
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Zip | 60914-4307
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Country | US
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Telephone | 815-922-4447
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043910B
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License Number State | IN
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