Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Marie Dejanovich, PTA

Individual provider Physical Therapy Assistant · NPI 1720483134

Lisa Marie Dejanovich, PTA is a Physical Therapy Assistant in Chicago, Illinois. Practices as a sole proprietor. Licensed in Illinois and Indiana.

Licensed in
IL, IN
In the registry since
2014
Specialties on file
2
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

13157 S Carondolet Ave
Chicago, IL 60633-1703
Phone: (773) 646-4126
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 160.003705 (IL)
Physical Therapy Assistant Taxonomy 225200000X · Licence 06004851A (IN)

Record details

NPI number1720483134
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedOctober 28, 2014
Last updated in NPPESOctober 28, 2014

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