Provider Demographics
NPI:1891788139
Name:SCHOENE, LISA M (DPM)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SCHOENE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 S GREENLEAF ST.
Mailing Address - Street 2:SUITE C
Mailing Address - City:PARK CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60085-5725
Mailing Address - Country:US
Mailing Address - Phone:847-263-6073
Mailing Address - Fax:847-244-7323
Practice Address - Street 1:351 S GREENLEAF ST
Practice Address - Street 2:SUITE C
Practice Address - City:PARK CITY
Practice Address - State:IL
Practice Address - Zip Code:60085
Practice Address - Country:US
Practice Address - Phone:847-263-6073
Practice Address - Fax:847-244-7323
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016004452213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U17562Medicare UPIN
210287Medicare ID - Type Unspecified