Active NPI
Lisa Marie Petrongelli, PSY.D, APRN-BC, FPA
- Psychiatric/Mental Health Nurse Practitioner
- Hoffman Estates, IL
National Provider Identifier
1306281332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 277000902
- Practice address
- 1776 Moon Lake Blvd
Hoffman Estates, IL 60169-1010 - Phone
- (847) 882-4181
- Fax
- (847) 882-4299
- NPI assigned
- May 3, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 277000902 | IL | Primary |
| Addiction (Substance Use Disorder) Psychologist | 103TA0400X | |||
| Women's Health Nurse Practitioner | 363LW0102X | 277000902 | IL | |
| Health Service Psychologist | 103TH0100X | |||
| Family Nurse Practitioner | 363LF0000X | 277000902 | IL | |
| Psychologist | 103T00000X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Nurse Practitioner | 363L00000X | 209004881 | IL | |
| Group Psychotherapy Psychologist | 103TP2701X | |||
| Adult Health Nurse Practitioner | 363LA2200X | 277000902 | IL |
Addresses
Primary practice location
1776 Moon Lake Blvd
Hoffman Estates, IL 60169-1010
Mailing address
1776 Moon Lake Blvd
Hoffman Estates, IL 60169-1010
Phone (847) 228-4181
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277000902 | IL | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred J. Halloran, MD, SC | Single Specialty | Current | Accepting new patients |
Locations
1015 S Evergreen Ave
Arlington Hts, IL 60005
Phone (770) 570-0021
11904 Oak Creek Pkwy
Huntley, IL 60142
Phone (770) 570-0021
Organizations & group practices 1
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": "1367539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774483200000",
"number": "1306281332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1776 MOON LAKE BLVD",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601691010",
"telephone_number": "847-228-4181",
"fax_number": "847-882-4299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1776 MOON LAKE BLVD",
"city": "HOFFMAN ESTATES",
"state": "IL",
"postal_code": "601691010",
"telephone_number": "847-882-4181",
"fax_number": "847-882-4299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRONGELLI",
"first_name": "LISA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PSY.D, APRN-BC, FPA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-05-03",
"last_updated": "2026-03-26",
"certification_date": "2026-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "IL",
"license": "277000902",
"primary": true
},
{
"code": "103TA0400X",
"taxonomy_group": "",
"desc": "Psychologist, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "IL",
"license": "277000902",
"primary": false
},
{
"code": "103TH0100X",
"taxonomy_group": "",
"desc": "Psychologist, Health Service",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "277000902",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IL",
"license": "209004881",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "IL",
"license": "277000902",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hoffman Estates, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.