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General NPI Number Information
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NPI Number | 1063990588
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Entity Type | Individual
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Provider Name | LISA HAMMONS APN
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Gender | Female
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Dates
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Enumeration Date | 08/06/2018
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Last Update Date | 08/06/2018
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Provider Practice Location Address
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Address Line | 14470 S LA GRANGE RD
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City | ORLAND PARK
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State | IL
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Zip | 60462-2630
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Country | US
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Telephone | 708-349-2227
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Fax | 708-349-5824
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Provider Business Mailing Address
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Address Line | 39 GRAYMOOR LN
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1211
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Country | US
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Telephone | 708-296-1665
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | PENDING
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License Number State | IL
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