Diane Lis O.d.s.c.

NPI #1437486511 in Elk Grove Vlg, Illinois

Provider Information

NPI Number: 1437486511
Entity Type: Organization
Organization Name: Diane Lis O.d.s.c.
Primary Specialty: Optometrist
Enumeration Date: Nov 10, 2009
Last Updated: Nov 10, 2009

Practice Location

Address: 801 MEACHAM RD
City: Elk Grove Vlg
State: Illinois
ZIP Code: 60007-3073
Phone: (847) 584-7090

Authorized Official

Name: DR. DIANE MARIE LIS, O.D.
Title: OPTOMETRIST
Phone: (630) 205-5222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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