=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356241053
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA MARIE SANCHEZ APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/06/2026
-----------------------------------------------------
Last Update Date | 11/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 636 RAYMOND DR STE 205
-----------------------------------------------------
City | NAPERVILLE
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60563-9791
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-717-2300
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 0N451 CLOOS CT
-----------------------------------------------------
City | WINFIELD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60190-1803
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 630-643-0174
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0200X
-----------------------------------------------------
Taxonomy Name | Pediatric Nurse Practitioner
-----------------------------------------------------
License Number | 209.037062
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------