Provider Demographics
NPI:1124148762
Name:SHERMAN, LISA (DN)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 W MONTROSE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-1413
Mailing Address - Country:US
Mailing Address - Phone:773-463-7760
Mailing Address - Fax:773-463-7761
Practice Address - Street 1:2952 W MONTROSE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-1413
Practice Address - Country:US
Practice Address - Phone:773-463-7760
Practice Address - Fax:773-463-7761
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181000331172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01637953OtherBLUE CROSS/BLUE SHIELD