Lisa Katherine Fasone, PA-C

NPI #1932743432 in Rockford, Illinois

Provider Information

NPI Number: 1932743432
Entity Type: Individual
Name: Lisa Katherine Fasone, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 29, 2019
Last Updated: Oct 29, 2019

Practice Location

Address: 1502 PARKVIEW AVE
City: Rockford
State: Illinois
ZIP Code: 61107-1821
Phone: (815) 381-7250

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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