Individual provider Active NPI

Lisa A. Moore, M.D.

  • Anesthesiology Physician
  • Chicago, IL
National Provider Identifier
1679584767
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
036095350 Issued in IL
Practice address
2900 N Lake Shore Dr
Chicago, IL 60657-5640
Phone
(773) 665-3000
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X 036095350 IL
Anesthesiology Physician 207L00000X 036095350 IL Primary

Addresses

Primary practice location

2900 N Lake Shore Dr
Chicago, IL 60657-5640

Mailing address

185 Penny Ave
East Dundee, IL 60118-1454
Phone (847) 836-7015

Other practice location 1

3134 N Clark St
Chicago, IL 60657-4414
Phone (773) 766-4949

Other identifiers 1

IdentifierTypeStateIssuer
036095350MedicaidIL

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address lmoore272453@direct.myadvocateaurora.org Direct
Direct Messaging Address lmoore272453@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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120224000824 IL Practitioner - Anesthesiology 6800054610 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3134 N Clark St
Chicago, IL 60657-4414
Phone (773) 296-5420

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036095350ILMDInterventional Pain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northstar Anesthesia of Illinois, LLC Anesthesiology CurrentSince Apr 9, 2022 Accepting new patients
Elite Anesthesia Providers, LTD Anesthesiology CurrentSince Jun 20, 2024 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 24, 2023 Accepting new patients
Midwest Anesthesiologists, LTD. Anesthesiology CurrentSince Dec 1, 2021 Accepting new patients
Midwest Anesthesia Partners, LLC Anesthesiology CurrentSince Oct 20, 1999 Accepting new patients
Advocate Health and Hospitals Corporation CurrentSince Jan 24, 2023 Accepting new patients

Locations

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

2900 N Lakeshore
Chicago, IL 60657
Phone (773) 665-3240

3134 N Clark St
Chicago, IL 60657
Phone (312) 766-4949

3407 Momentum Pl
Chicago, IL 60689

29373 Network Pl
Chicago, IL 60673

185 Penny Ave
East Dundee, IL 60118
Phone (847) 836-7015

17800 Kedzie Ave
Hazel Crest, IL 60429
Phone (708) 213-4200

19110 Darvin Dr
Ste A
Mokena, IL 60448
Phone (708) 478-8889

19110 Darvin Dr
Mokena, IL 60448
Phone (708) 478-8889

720 Brom Ct
Ste 201
Naperville, IL 60540
Phone (331) 330-8559

3 N Washington St
Naperville, IL 60540
Phone (630) 357-6540

1003 Pawlak Pkwy
New Lenox, IL 60451
Phone (708) 226-3300

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

7340 W College Dr
Palos Heights, IL 60463
Phone (708) 361-3233

10330 S Roberts Rd
Palos Hills, IL 60465
Phone (708) 237-7200

1775 W Dempster St
Park Ridge, IL 60068
Phone (847) 723-5150

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

18200 La Grange Rd
Tinley Park, IL 60487
Phone (708) 570-2490

Organizations & group practices 6

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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1679584767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 PENNY AVE",
            "city": "EAST DUNDEE",
            "state": "IL",
            "postal_code": "601181454",
            "telephone_number": "847-836-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N LAKE SHORE DR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575640",
            "telephone_number": "773-665-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3134 N Clark St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606574414",
            "country_code": "US",
            "telephone_number": "773-766-4949",
            "fax_number": "312-766-4909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "IL",
            "license": "036095350",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036095350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036095350",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmoore272453@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmoore272453@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "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": "3134 N Clark St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606574414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.