Moore, Lisa A.

Moore, Lisa A. is an individual health care provider with primary practice located at 2900 N Lake Shore Dr , Chicago IL 60657-5640. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Interventional Pain Medicine, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Moore, Lisa A. can be contacted via phone (773) 665-3000.

Contact Information

Primary practice address
2900 N Lake Shore Dr Chicago IL 60657-5640
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 036095350 Illinois
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 036095350 Illinois

Profile Details

NPI number 1679584767
LBN Legal business name Moore, Lisa A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2006
Last updated Feb 2nd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679584767 NPPES
Illinois MEDICAID 036095350

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