Lisa Marie Skowron, MAMS, BCO, BADO, CCA

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

23605 N High Ridge Dr
Chrysalis Anaplastology Inc
Lake Zurich, IL 60047-9048

Phone

(847) 719-2984

Fax

(847) 719-2984

NPI assigned

Jun 29, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Miss Lisa Marie Skowron Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Chrysalis Anaplastology & Ocularistry Inc

  • Prosthetic/Orthotic Supplier
  • Lake Zurich, IL
  • NPI 1407013717
  NPD Authorized official

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174720452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23605 N HIGH RIDGE DR",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600479048",
            "telephone_number": "847-719-2984",
            "fax_number": "847-719-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23605 N HIGH RIDGE DR",
            "address_2": "CHRYSALIS ANAPLASTOLOGY INC",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600479048",
            "telephone_number": "847-719-2984",
            "fax_number": "847-719-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOWRON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "MAMS, BCO, BADO, CCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE TAX ID NUMBER",
            "identifier": "33085536",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SKOWRON",
            "middle_name": "MARIE",
            "prefix": "MISS",
            "credential": "MAMS, BCO, BADO, CCA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Specialist in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.