Active NPI
Edward E Lisberg, MD
- Allergy Physician
- Chicago, IL
National Provider Identifier
1972519320
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy Physician
- License
- 036067746
- Practice address
- 1912 N Leavitt St
Chicago, IL 60647-4409 - Phone
- (773) 627-8737
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036067746 | IL | |
| Allergy Physician | 207KA0200X | 036067746 | IL | Primary |
Addresses
Primary practice location
1912 N Leavitt St
Chicago, IL 60647-4409
Mailing address
1912 N Leavitt St
Chicago, IL 60647-4409
Phone (773) 627-8737
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036067746 | IL | MD | Allergy Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587513600000",
"number": "1972519320",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1912 N LEAVITT ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606474409",
"telephone_number": "773-627-8737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1912 N LEAVITT ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606474409",
"telephone_number": "773-627-8737"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISBERG",
"first_name": "EDWARD",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2020-04-22",
"certification_date": "2020-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IL",
"license": "036067746",
"primary": false
},
{
"code": "207KA0200X",
"taxonomy_group": "",
"desc": "Allergy & Immunology, Allergy",
"state": "IL",
"license": "036067746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.