Individual provider Active NPI

Chibuzo Lasisi

  • Psychiatric/Mental Health Nurse Practitioner
  • New Lenox, IL
National Provider Identifier
1013661859
Registry record updated Mar 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
277004019 Issued in IL
Practice address
305 N Vine St Unit 100a
New Lenox, IL 60451-1652
Phone
(815) 435-4055
NPI assigned
Feb 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 277004019 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 277004019 IL Primary

Addresses

Primary practice location

305 N Vine St Unit 100a
New Lenox, IL 60451-1652

Mailing address

4749 Lincoln Mall Dr Ste 202H
Matteson, IL 60443-3826

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220806000666 IL Practitioner - Nurse Practitioner 1658753660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Will County Community Health CenterGroup PAC ID 5395633317, shared by 3 NPIs, 19 clinicians
Harvey Emergency Physicians PLLCGroup PAC ID 9436486560, 50 clinicians

Practice addresses (Care Compare)

1106 Neal Ave
Joliet, IL 60433-2548
Phone (815) 727-8670

1600 Torrence Ave
Calumet City, IL 60409-5430
Phone (954) 939-5000

305 N Vine St
Unit 100a
New Lenox, IL 60451-1652
Phone (815) 435-4055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
277004019ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hallow Health and Psychiatric Services LLC Psychiatric/Mental Health CurrentSince Feb 25, 2025 Accepting new patients
Harvey Emergency Physicians, PLLC CurrentSince Feb 1, 2023 Accepting new patients

Locations

1600 Torrence Ave
Calumet City, IL 60409
Phone (708) 730-1300

19550 Governors Hwy
Flossmoor, IL 60422
Phone (708) 799-8400

1 Ingalls Dr
Harvey, IL 60426
Phone (708) 333-2300

4749 Lincoln Mall Dr
Ste 202H
Matteson, IL 60443
Phone (312) 561-6215

305 N Vine St
Unit 100A
New Lenox, IL 60451
Phone (815) 435-4055

5320 159th St
Ste 303B
Oak Forest, IL 60452
Phone (815) 435-4055

Interoperability endpoints

  • Direct secure messaging: clasisi271326@uchospital.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774051200000",
    "number": "1013661859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4749 LINCOLN MALL DR STE 202H",
            "city": "MATTESON",
            "state": "IL",
            "postal_code": "604433826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N VINE ST UNIT 100A",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604511652",
            "telephone_number": "815-435-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LASISI",
        "first_name": "CHIBUZO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-10",
        "last_updated": "2026-03-21",
        "certification_date": "2026-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "277004019",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "277004019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Lenox, IL

Sources for this page

Verify at the official NPI Registry.