Provider Demographics
NPI:1528266434
Name:DO, LISA VAN HONG (PHARMD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:VAN HONG
Last Name:DO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7906 KOSTNER AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-3534
Mailing Address - Country:US
Mailing Address - Phone:847-530-6202
Mailing Address - Fax:
Practice Address - Street 1:811 ELMHURST RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-5605
Practice Address - Country:US
Practice Address - Phone:847-439-4230
Practice Address - Fax:847-439-8912
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051.290061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist