| Doctor Name: | LISA M. SOBOLESKI |
| NPI Number: | 1053427682 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | 763 |
| Business Practice Address: | 201 N Mayfair Rd 2nd Floor Wauwatosa, WI - 532264216 |
| Business Phone Number: | 4147718228 |
| Business Fax Number: | 4142562483 |
| Mailing Address: | 201 N Mayfair Rd, 2nd Floor WAUWATOSA |
| State: | WI |
| Postal Code: | 532264216 |
| Phone Number: | 4147718228 |
| Fax Number: | 4142562483 |
| NPI Enumeration Date: | 08/23/2006 |
| NPI Last Update Date: | 09/23/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 763 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |