DR. LISA MICHELLE HENRY-REID (NPI# 1366740284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366740284 |
| Entity Type | Individual |
| Full Name | DR. LISA MICHELLE HENRY-REID |
| Credential | M.D. |
| Practice Address |
1900 W Polk St Room 1111 Chicago IL 60612-3723 |
| Practice Telephone | 3128643585 |
| Practice Fax Number | 3128649721 |
| Mailing Telephone | 3128643585 |
| Mailing Fax Number | 3128649721 |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2020-08-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 036-073772 | IL | Allopathic & Osteopathic Physicians |
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
036073772 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1900 W POLK ST ROOM 1111 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60612-3723 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861478893 | Steven R Bonomo | Surgery | 1900 W Polk St, Chicago, IL 60612-3723 | 2005-12-21 |
| 1679182760 | Aruna N Sasikumar | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2020-07-24 |
| 1174144810 | Chelsae L May | Student in an Organized Health Care Education/Training Program | 1900 W Polk St, Chicago, IL 60612-3723 | 2020-05-05 |
| 1750930475 | Kimberly Rhodes | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-09-05 |
| 1992363584 | Rachel Elizabeth Earl | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1356909949 | Marie Roman | Social Worker | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1265090856 | Kristina Coenen | Counselor | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-05-30 |
| 1205396512 | Luisa Patricia Guerrero | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-22 |
| 1366902876 | Liza Patria Gaines | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-21 |
| 1629538137 | Courtney Jenkins | Registered Nurse | 1900 W Polk St, Chicago, IL 60612-3723 | 2019-03-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144839739 | Sandhya Shri Kannayiram | Internal Medicine | 1901w Harrison Street, Chicago, IL 60612 | 2020-07-29 |
| 1568080174 | Nastaran Ordoyo Haghani Rad | Student in an Organized Health Care Education/Training Program | 1950 W. Polk Street, Room 6203, Chicago, IL 60612 | 2020-07-09 |
| 1669090403 | Marianne Gagnon-konamna | Student in an Organized Health Care Education/Training Program | 1950 West Polk Street, Chicago, IL 60612 | 2020-07-08 |
| 1922625672 | Tanya Montgomery Nee Brown | Pediatrics | 1950 West Polk Street, Neonatal and Perinatal Department, Chicago, IL 60612 | 2020-06-29 |
| 1124643028 | Ashley Swan | Dentist | 801 S. Paulina St, Uic College of Dentistry - Endodontics Clinic, Chicago, IL 60612 | 2020-06-16 |
| 1831711381 | Baillie Anne Bronner | Obstetrics & Gynecology | 1653 W Congress Pkwy Chicago, Il 60612, Chicago, IL 60612 | 2020-05-07 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1275153777 | Isac Lim | Student in an Organized Health Care Education/Training Program | 1234 S. Wells, Chicago, IL 60612 | 2020-04-24 |
| 1578183414 | Zachary Belden | Student in an Organized Health Care Education/Training Program | Uic Psychiatry Residency 912 S. Wood St., Rm 130b Npi-s (mc 913), Chicago, IL 60612 | 2020-04-21 |
| 1548880560 | Christina Nunez | Student in an Organized Health Care Education/Training Program | 801 S. Paulina Street, M/c 850, Chicago, IL 60612 | 2020-04-20 |
| Find all providers in zip 60612 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417259979 | Adolescent and Young Adult Place Ltd | Pediatrics | 9 N Cicero Ave, Chicago, IL 60644-3602 | 2010-12-03 |
| 1942520671 | Cherie Priya Dhar | Pediatrics | 1440 N Dayton St Fl 3, Chicago, IL 60642-2644 | 2010-06-04 |
| 1649475377 | Lisa Kantz Simons | Pediatrics | 225 E Chicago Ave # Ms 161b, Chicago, IL 60611-2991 | 2007-06-21 |
| 1417966789 | Sudha V. Shah | Pediatrics | 1516 W Devon Ave, Chicago, IL 60660-1314 | 2006-08-05 |
| 1447259759 | Kimberly A. Koval | Pediatrics | 1030 N Clark St, Suite 400, Chicago, IL 60610-5467 | 2005-07-19 |
| 1235451402 | Felicia Scott | Pediatrics | 1725 W Harrison St, Suite 710, Chicago, IL 60612-3841 | 2010-02-15 |
| 1124260625 | Sonia Wengerhoff | Pediatrics | 2835 N Sheffield Ave, Suite 501, Chicago, IL 60657-5081 | 2009-03-30 |
| 1275773475 | My Pediatrics Associates LLC | Pediatrics | 2875 W 19th St, Chicago, IL 60623-3501 | 2009-02-27 |
| 1528233087 | Nava Segall Md Sc | Pediatrics | 4116 N Lincoln Ave, Chicago, IL 60618-3028 | 2008-04-25 |
| 1093934275 | The Board of Trustees of The University of Illinois | Pediatrics | 840 S Wood St, Chicago, IL 60612-4325 | 2007-04-25 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.