Individual provider Active NPI

Anthony David Lisuzzo, PA

  • Physician Assistant
  • Libertyville, IL
National Provider Identifier
1558771543
Registry record updated May 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085-005363 Issued in IL
Practice address
825 S Milwaukee Ave
Libertyville, IL 60048-3218
Phone
(847) 634-1766
NPI assigned
Apr 30, 2014
Last updated
May 5, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601010096 MI
Physician Assistant 363A00000X 085-005363 IL Primary

Addresses

Primary practice location

825 S Milwaukee Ave
Libertyville, IL 60048-3218

Mailing address

29373 Network PL
Chicago, IL 60673-1293
Phone (847) 390-5900

Other practice location 1

1900 Wealthy St SE Ste 290
Grand Rapids, MI 49506-2969
Phone (616) 774-8345

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
Direct Messaging Address alisuzzo98103@direct.myadvocateaurora.org Direct

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
I20150309001592 IL Practitioner - Physician Assistant 4082930185 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Village GRN
Suite 120
Lincolnshire, IL 60069-3095
Phone (847) 634-1766

214 McHenry Rd
Buffalo Grove, IL 60089-6748
Phone (847) 459-1160

801 S Milwaukee Ave
Libertyville, IL 60048-3204
Phone (847) 279-0061

801 S Milwaukee Ave BLDG
Suite 880
Libertryville, IL 60048-3204
Phone (847) 990-5910

825 S Milwaukee Ave
Libertyville, IL 60048-3218
Phone (847) 362-1393

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-005363ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advocate Health and Hospitals Corporation CurrentSince Dec 14, 2018 Accepting new patients
Advocate Health & Hospitals Corporation CurrentSince Dec 14, 2018 Accepting new patients
Advocate Health and Hospitals Corporation Past Accepting new patients

Locations

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

29373 Network Pl
Chicago, IL 60673

825 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-1393

Interoperability endpoints

  • Direct secure messaging: alisuzzo98103@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 4

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": "1398816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777939200000",
    "number": "1558771543",
    "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": "606731293",
            "telephone_number": "847-390-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 S MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600483218",
            "telephone_number": "847-634-1766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Wealthy St SE Ste 290",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495062969",
            "country_code": "US",
            "telephone_number": "616-774-8345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LISUZZO",
        "first_name": "ANTHONY",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-30",
        "last_updated": "2026-05-05",
        "certification_date": "2026-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601010096",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-005363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "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": "825 S Milwaukee Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alisuzzo98103@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "825 S Milwaukee Ave",
            "city": "Libertyville",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600483218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Libertyville, IL

Sources for this page

Verify at the official NPI Registry.