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General NPI Number Information
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NPI Number | 1538541032
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Entity Type | Individual
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Provider Name | LISA RAUSCHERT MD
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 12/18/2021
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Provider Practice Location Address
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Address Line | 4440 W 95TH STREET ADVOCATE CHRIST MEDICAL CENTER
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 847-226-6868
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Fax |
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Provider Business Mailing Address
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Address Line | 4440 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2600
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Country | US
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Telephone | 708-684-6949
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125.067380
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | LP03636
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 036.156219
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License Number State | IL
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