Organization Active NPI

Asthma and Allergy Center of Chicago SC

  • Allergy Physician
  • River Forest, IL
National Provider Identifier
1861503153
Registry record updated Nov 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
036067746 Issued in IL
Legal business name
ASTHMA AND ALLERGY CENTER OF CHICAGO SC
Practice address
7420 Central Ave
Suite 2020
River Forest, IL 60305-1800
Phone
(708) 366-9300
Fax
(708) 366-9310
NPI assigned
Aug 31, 2006
Last updated
Nov 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2009

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

Authorized official

Name
Dr. Edward E Lisberg, MD
Title
Director
Phone
(708) 366-9300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X 036067746 IL Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 036067746 IL

Addresses

Primary practice location

7420 Central Ave
Suite 2020
River Forest, IL 60305-1800

Mailing address

7420 Central Ave
Suite 2020
River Forest, IL 60305-1800

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0992792Asthma and Allergy Center of Chicago7420 Central Ave - Ste 2020, River Forest, IL 60305Certificate of waiverOct 24, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1861503153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7420 CENTRAL AVE",
            "address_2": "SUITE 2020",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7420 CENTRAL AVE",
            "address_2": "SUITE 2020",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051800",
            "telephone_number": "708-366-9300",
            "fax_number": "708-366-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTHMA AND ALLERGY CENTER OF CHICAGO SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "LISBERG",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-366-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": "IL",
            "license": "036067746",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036067746",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in River Forest, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.