Asthma and Allergy Center of Chicago SC
Organization Active NPI Allergy Physician · River Forest, IL
NPI 1861503153 · NPPES record last updated Nov 30, 2009
Key facts
- NPI
- 1861503153
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Allergy Physician 207KA0200X
- License
- 036067746 (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
- Organization subpart
- No
Authorized official
- Name
- Dr. Edward E Lisberg, MD
- Title
- Director
- Phone
- (708) 366-9300
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0992792 | Asthma and Allergy Center of Chicago | Certificate of waiver | Oct 24, 2027 |
National Provider Directory
Locations
7420 Central Ave
Ste 2020
River Forest, IL 60305
Phone (708) 366-9300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy Physician |
207KA0200X | 036067746 | IL | Yes |
| Internal Medicine Physician |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036067746 | Medicaid | IL | |
| 31603461 | Other | IL | BLUE CROSS BLUE SHIELD |
Other providers in River Forest, IL
- Anna Dowd-Apn LLC
- Art of Natural Healing LTD.
- Asad a Bakir MDSC
- Ashland & Vine Home Health Care Inc
- Ashley Graves Therapeutic Services
- Audionova LLC
- Asad A Bakir
- Joseph Brendan Baptist
- Barbara Martin P.C.
- Dean A Bauer
All providers in River Forest, IL · Allergy Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.