Provider Demographics
NPI:1457566432
Name:KRAMMER, LISA MARIE (NP)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:KRAMMER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 W 125TH ST
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1927
Mailing Address - Country:US
Mailing Address - Phone:708-448-4889
Mailing Address - Fax:
Practice Address - Street 1:251 E HURON ST
Practice Address - Street 2:16TH FLOOR FEINBERG PAVILLION
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-927-7476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health