Individual provider Active NPI

Lisa K Siby

  • Nurse Practitioner
  • Schaumburg, IL
National Provider Identifier
1033650940
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
209015656 Issued in IL
Practice address
1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832
Phone
(630) 701-9009
NPI assigned
Mar 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 209015656 IL Primary

Addresses

Primary practice location

1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832

Mailing address

1355 Remington Rd
Suite H
Schaumburg, IL 60173-4832
Phone (630) 701-9009

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
I20170316000105 IL Practitioner - Nurse Practitioner 6406131325 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209015656ILMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Psychiatry & Counseling, SC. CurrentSince Apr 2, 2018 Accepting new patients
Paragon Clinical LLC Nurse Practitioner CurrentSince Jan 22, 2020 Accepting new patients
Paragon Clinical Midwest, LLC Nurse Practitioner Past Accepting new patients

Locations

1 Tiffany Pt
Ste 206
Bloomingdale, IL 60108
Phone (630) 924-1160

1333 Burr Ridge Pkwy
Ste 200
Burr Ridge, IL 60527
Phone (630) 308-8706

Dept 5973
Carol Stream, IL 60122

1000 Dixon Rd
Rock Falls, IL 61071
Phone (815) 625-8510

Organizations & group practices 3

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": "1489104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489104000000",
    "number": "1033650940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "SUITE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734832",
            "telephone_number": "630-701-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 REMINGTON RD",
            "address_2": "SUITE H",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734832",
            "telephone_number": "630-701-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIBY",
        "first_name": "LISA",
        "middle_name": "K",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-10",
        "last_updated": "2017-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209015656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.