Provider Demographics
NPI:1376979815
Name:ROUNDS, LISA K (CPNP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:K
Last Name:ROUNDS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Mailing Address - Street 1:70 MEADOWVIEW CTR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KANKAKEE
Mailing Address - State:IL
Mailing Address - Zip Code:60901-2047
Mailing Address - Country:US
Mailing Address - Phone:815-802-0022
Mailing Address - Fax:815-802-0011
Practice Address - Street 1:70 MEADOWVIEW CTR
Practice Address - Street 2:SUITE 300
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2047
Practice Address - Country:US
Practice Address - Phone:815-802-0022
Practice Address - Fax:815-802-0011
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2015-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL209010683363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics