Provider Demographics
NPI:1679953954
Name:ISSAC, LYDIA ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:LYDIA
Middle Name:ELIZABETH
Last Name:ISSAC
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:29373 NETWORK PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1293
Mailing Address - Country:US
Mailing Address - Phone:847-390-5900
Mailing Address - Fax:
Practice Address - Street 1:2535 SOUTH MARTIN LUTHER KING DRIVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-842-7117
Practice Address - Fax:312-326-2102
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-156634207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease