Provider Demographics
NPI:1386864098
Name:FARINA, LISA DEANNE
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:DEANNE
Last Name:FARINA
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 1:11826 LELAND LANE
Mailing Address - Street 2:
Mailing Address - City:HUNTLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60142-8111
Mailing Address - Country:US
Mailing Address - Phone:847-669-2021
Mailing Address - Fax:847-515-1385
Practice Address - Street 1:11826 LELAND LANE
Practice Address - Street 2:
Practice Address - City:HUNTLEY
Practice Address - State:IL
Practice Address - Zip Code:60142-8111
Practice Address - Country:US
Practice Address - Phone:847-669-2021
Practice Address - Fax:847-515-1385
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist