person
Lois Marlene Dishman-cooper, MPAS,PA-C
Medical Physician Assistant in Flora, Illinois
NPI 1851476238

Lois Marlene Dishman-cooper is a Medical Physician Assistant based in Flora, IL and is specialized in Medical. Lois Marlene Dishman-cooper practices in Flora, IL and has the professional credentials of MPAS,PA-C. The NPI Number for Lois Marlene Dishman-cooper is 1851476238 and holds a License No. 085-002930 (Illinois).

The current practice location address for Lois Marlene Dishman-cooper is 929 Stacey Burk Dr, Flora, IL and can be reached out via phone at 618-662-2131 and via fax at 618-662-3077.

Location: 929 Stacey Burk Dr, Flora, IL, 62839-3241
person
Provider Profile Details
NPI Number
1851476238
Provider Name
Lois Marlene Dishman-cooper
Credential
MPAS,PA-C
Provider Entity Type
Individual
Gender
Female
Address
929 Stacey Burk Dr, Flora, IL, 62839-3241
Phone Number
618-662-2131
Fax Number
618-662-3077
Provider Enumeration Date
10/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00004500 01 FL PA PRESCRIBER NUMBER
PA9101866 01 FL PA LICENSE NUMBER
085-002930 01 IL LICENSE NUMBER
291816100 05 FL
MED-PAC-LIC-26883 01 MT STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
929 Stacey Burk Dr
City
State
Zip
62839-3241
Phone Number
618-662-2131
Fax Number
618-662-3077
person
Provider Business Mailing Address Details
Address
929 Stacey Burk Dr
City
State
Zip
62839-3241
Phone Number
618-662-2131
Fax Number
618-662-3077
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
085-002930 (Illinois)
Definition
Definition to come...
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