Lisa Peng, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

036104558 Issued in IL

Practice address

31 W 155TH St
Harvey, IL 60426-3556

Phone

(708) 596-5177

Fax

(708) 339-3583

NPI assigned

Nov 29, 2006

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

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Family Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Harvey, IL
  • NPI 1093855736

  General Practice

  Medicare reassignment NPD
• Family Christian Health Center

  dba FCHC-Integrative Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Harvey, IL
  • NPI 1013744325
  NPD
• Family Christian Health Center

  dba Family Christian Health Center-Dolton

  • Federally Qualified Health Center (FQHC)
  • Dolton, IL
  • NPI 1336433382
  NPD (past)
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1235206897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-339-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-339-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "LISA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IL",
            "license": "036104558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036104558",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jagu Patel
• Nipa V Patel, MD
• Ricky Patel
• Patient Manager Services
• Peace Medical Center, S.C.
• Carol Peppers-Taylor, LCPC
• Anita Marie Phillips
• Physicians Community Medical Center Harvey, S.C.
• Gwendolyn Denise Pinkney, FNP
• Pramod K Anand, M.D. LTD (Pramod K Anand, M.D.)

• General Practice Physician in Harvey, IL
• Providers in Harvey, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.