Provider Demographics
NPI:1194509315
Name:RISSMAN, LISSETTE ELIZABETH (FNP-BC)
Entity type:Individual
Prefix:
First Name:LISSETTE
Middle Name:ELIZABETH
Last Name:RISSMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:LISSETTE
Other - Middle Name:
Other - Last Name:TIGREROS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2845 SILVER SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:YORKVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60560-6001
Mailing Address - Country:US
Mailing Address - Phone:630-636-0568
Mailing Address - Fax:
Practice Address - Street 1:1720 N ORCHARD RD STE 140
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-6449
Practice Address - Country:US
Practice Address - Phone:331-282-2016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.472824163WP2201X
IL209.028262363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care