Individual provider Active NPI

Lisa Genualdi, CPNP

  • Pediatric Nurse Practitioner
  • Chicago, IL
National Provider Identifier
1295031342
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
209008616 Issued in IL
Practice address
2300 N Childrens PLZ
Chicago, IL 60614-3363
Phone
(773) 880-4000
NPI assigned
Feb 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 209008616 IL Primary

Addresses

Primary practice location

2300 N Childrens PLZ
Chicago, IL 60614-3363

Mailing address

2300 N Childrens PLZ
Chicago, IL 60614-3363
Phone (773) 880-4000

Other identifiers 1

IdentifierTypeStateIssuer
APN LICENSE NUMBEROtherIL209008616

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
I20210301001221 IL Practitioner - Nurse Practitioner 0749696649 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lurie Children'S Medical Group Inc CurrentSince Nov 21, 2020 Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

Claims Remittance
Carol Stream, IL 60122

225 E Chicago Ave
#37
Chicago, IL 60611
Phone (312) 227-6160

225 E Chicago Ave
#118
Chicago, IL 60611

225 E Chicago Ave
Fl 16
Chicago, IL 60611

2515 N Clark St
Chicago, IL 60614
Phone (312) 227-6010

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

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": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297123200000",
    "number": "1295031342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N CHILDRENS PLZ",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606143363",
            "telephone_number": "773-880-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENUALDI",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IL",
            "license": "209008616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "209008616",
            "identifier": "APN LICENSE NUMBER",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.