Provider Demographics
NPI:1871651331
Name:KORMAN, LISA JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:JOY
Last Name:KORMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:LISA
Other - Middle Name:JOY
Other - Last Name:GOLDENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NONE
Mailing Address - Street 1:64 OLD ORCHARD SHOPPING CTR
Mailing Address - Street 2:SUITE 517
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1425
Mailing Address - Country:US
Mailing Address - Phone:847-677-2165
Mailing Address - Fax:847-677-2166
Practice Address - Street 1:64 OLD ORCHARD SHOPPING CTR
Practice Address - Street 2:SUITE 517
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60077-1425
Practice Address - Country:US
Practice Address - Phone:847-677-2165
Practice Address - Fax:847-677-2166
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1725792084P0800X, 2084P0804X
IL2084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry