Lisa Heswall, PTA
Individual provider Active NPI Physical Therapy Assistant · Bannockburn, IL
NPI 1972550705 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1972550705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 2101 Waukegan Rd
Suite 110
Bannockburn, IL 60015-1836 - Phone
- (847) 914-0544
- NPI assigned
- May 27, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160-001543 | IL | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | IL | Yes |
Addresses
Primary practice location
2101 Waukegan Rd
Suite 110
Bannockburn, IL 60015-1836
Mailing address
8930 Waukegan Rd
Suite 200 - Attn: Raquel Leon
Morton Grove, IL 60053-2126
Phone (847) 324-3976
Other providers in Bannockburn, IL
- Jeffrey Warren Hamilton
- Laura Hamilton
- Kevin C. Harang
- Laura Aline Harwood
- Bryan Louis Hersh
- John Daley Higgins
- Karen Marie Holub
- Anthony J Horwitz
- Yuxi Huang
- Huckleberry Counseling, LLC
All providers in Bannockburn, IL · Physical Therapy Assistant in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.