Provider Demographics
NPI:1821640509
Name:TOMADA, LIZLI YAP (PT)
Entity Type:Individual
Prefix:
First Name:LIZLI
Middle Name:YAP
Last Name:TOMADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5885 FOREST VIEW RD APT 326
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2980
Mailing Address - Country:US
Mailing Address - Phone:773-829-1980
Mailing Address - Fax:
Practice Address - Street 1:5885 FOREST VIEW RD APT 326
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2980
Practice Address - Country:US
Practice Address - Phone:773-829-1980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-12
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL70016442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist