Individual provider Active NPI

Lisa M Grossman

  • Advanced Practice Midwife
  • Park Ridge, IL
National Provider Identifier
1215392576
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
209.013705 Issued in IL
Practice address
1875 Dempster St
Suite 465
Park Ridge, IL 60068-1129
Phone
(847) 825-1100
NPI assigned
Dec 30, 2015
Last updated
Sep 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Clinical Nurse Specialist 364SW0102X 209.013706 IL
Advanced Practice Midwife 367A00000X 209.013705 IL Primary

Addresses

Primary practice location

1875 Dempster St
Suite 465
Park Ridge, IL 60068-1129

Mailing address

29373 Network PL
Chicago, IL 60673-1129
Phone (847) 390-5900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lgrossman251720@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160429000813 IL Practitioner - Certified Nurse Midwife (CNM) 1850690686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1875 Dempster St
Park Ridge, IL 60068-1186
Phone (847) 723-8640

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209.013706ILMDWomen's Health Clinical Nurse Specialist
209.013705ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients
Advocate Health and Hospitals Corporation Current Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Mar 1, 2020 Accepting new patients

Locations

214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160

29373 Network Pl
Chicago, IL 60673

1875 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-8640

1875 W Dempster St
Ste 465
Park Ridge, IL 60068
Phone (847) 318-9071

Interoperability endpoints

  • Direct secure messaging: lgrossman251720@direct.myadvocateaurora.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1451433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1215392576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29373 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731129",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 DEMPSTER ST",
            "address_2": "SUITE 465",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681129",
            "telephone_number": "847-825-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "LISA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-30",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SW0102X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Women's Health",
            "state": "IL",
            "license": "209.013706",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": "209.013705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lgrossman251720@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1875 Dempster St",
            "address_2": "Suite 465",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "1875 Dempster St",
            "address_2": "Suite 465",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.