Provider Demographics
NPI:1043590961
Name:DRUCKER, LISA F
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:F
Last Name:DRUCKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 E OHIO ST APT 2703
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4621
Mailing Address - Country:US
Mailing Address - Phone:312-415-0488
Mailing Address - Fax:
Practice Address - Street 1:400 E OHIO ST APT 2703
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4621
Practice Address - Country:US
Practice Address - Phone:312-415-0488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-23
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist