Provider Demographics
NPI:1659596864
Name:ROME, LISA SOKOL (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:SOKOL
Last Name:ROME
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:SOKOL
Other - Last Name:ROME
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:422 W DEMING PL APT 4
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6575
Mailing Address - Country:US
Mailing Address - Phone:918-691-6446
Mailing Address - Fax:918-481-6447
Practice Address - Street 1:NORTHWESTERN MEMORIAL HOSPITAL LAKE FOREST
Practice Address - Street 2:1000 N. WESTMORELAND RD
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045
Practice Address - Country:US
Practice Address - Phone:847-234-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0036114664207P00000X
IL036-114664207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine