Active NPI
Lisa A Reisinger, DPT
- Physical Therapist
- Gurnee, IL
National Provider Identifier
1811221161
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070-017422
- Practice address
- 3430 Grand Ave
#400
Gurnee, IL 60031-3741 - Phone
- (847) 782-9860
- Fax
- (847) 782-9866
- NPI assigned
- Sep 18, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070-017422 | IL | Primary |
Addresses
Primary practice location
3430 Grand Ave
#400
Gurnee, IL 60031-3741
Mailing address
625 Enterprise Dr
Oak Brook, IL 60523-8813
Phone (630) 575-1980
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-017422 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478476800000",
"number": "1811221161",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "625 ENTERPRISE DR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605238813",
"telephone_number": "630-575-1980",
"fax_number": "630-590-4329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3430 GRAND AVE",
"address_2": "#400",
"city": "GURNEE",
"state": "IL",
"postal_code": "600313741",
"telephone_number": "847-782-9860",
"fax_number": "847-782-9866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REISINGER",
"first_name": "LISA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-18",
"last_updated": "2016-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-017422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.