Lisa Verderber

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036101922 Issued in IL

Practice address

3612 Lake Ave
2C
Wilmette, IL 60091-1000

Phone

(847) 256-2020

NPI assigned

Jun 1, 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

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427846400000",
    "number": "1710924386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 LAKE AVE",
            "address_2": "2C",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3612 LAKE AVE",
            "address_2": "2C",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911000",
            "telephone_number": "847-256-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDERBER",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2015-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036101922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036101922",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Wegg Uzunlar, MD
• Hina R Valiani, APRN
• Pieter A Van Heule, D.C.
• Allison Field Vanhorn, ATC
• Axel Vargas, M.D.
• Victoria Y. Hass PHD, PLLC
• Village Dermatology, SC
• Village of Wilmette
• Village of Wilmette
• Kannan Vinaitheerthan, LCSW

• Ophthalmology Physician in Wilmette, IL
• Providers in Wilmette, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2015; 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.