Illissa Jasmine Lancaster

NPI #1114759776 in Maywood, Illinois

Provider Information

NPI Number: 1114759776
Entity Type: Individual
Name: Illissa Jasmine Lancaster
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 14, 2024
Last Updated: Aug 14, 2024

Practice Location

Address: 2160 S 1ST AVE
City: Maywood
State: Illinois
ZIP Code: 60153-3328
Phone: (608) 320-7248

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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