Provider Demographics
NPI:1952354250
Name:WALINSKI, LISA (DO)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:
Last Name:WALINSKI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 N EOLA RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9409
Mailing Address - Country:US
Mailing Address - Phone:630-646-6250
Mailing Address - Fax:630-236-2363
Practice Address - Street 1:1222 N EOLA RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9409
Practice Address - Country:US
Practice Address - Phone:630-646-6250
Practice Address - Fax:630-236-2363
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36105587207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036105587Medicaid
ILH98637Medicare UPIN