Michael Lisuzzo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070021012 Issued in IL

Practice address

10300 Village Circle Dr
Palos Park, IL 60464-3541

Phone

(708) 361-3683

NPI assigned

Mar 9, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Powerback Rehabilitation LLC

  • Physical Therapist
  • O Fallon, IL
  • NPI 1982018362
  Medicare reassignment NPD
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Woodbridge, VA
  • NPI 1790640761
  NPD

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552089600000",
    "number": "1770041675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6007 S KILPATRICK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295415",
            "telephone_number": "773-585-4988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300 VILLAGE CIRCLE DR",
            "city": "PALOS PARK",
            "state": "IL",
            "postal_code": "604643541",
            "telephone_number": "708-361-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISUZZO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-09",
        "last_updated": "2019-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070021012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert George Kosobucki, D.D.S.
• David M Kozal, DDS
• Melissa Lieser
• Lifestyles Academy, Inc.
• Robert F Lindgren, MD
• Yvette Lombardi
• Kaitlyn Lonero
• Angela H Mahome, MD
• Shaina Mann, PA-C
• Jessica M Marganski

• Physical Therapist in Palos Park, IL
• Providers in Palos Park, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.