LISA M MORAN (NPI# 1992252399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992252399 |
| Entity Type | Individual |
| Full Name | LISA M MORAN |
| Credential | N.P. |
| Practice Address |
360 Station Dr Ste 120 Crystal Lake IL 60014-7994 |
| Mailing Address |
4309 W Medical Center Dr Ste A200 Mchenry IL 60050-8437 |
| Practice Telephone | 8154778900 |
| Practice Fax Number | 8154777160 |
| Mailing Telephone | 8157598070 |
| Mailing Fax Number | 8157594931 |
| Enumeration Date | 2016-09-02 |
| Last Update Date | 2020-09-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209015062 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | STATE LICENSE | 209015062 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10370 Haligus Rd Ste 200, Huntley, IL 601429582 | 8157598070 | 8157594931 |
| 4309 W Medical Center Dr, Suite A200, Mchenry, IL 600508419 | 8157598070 | 8157594931 |
| 4309 W Medical Center Dr Ste A200, Mchenry, IL 600508437 | 8157598070 | 8157594931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104030584 | Lisa Kathleen Moran | Social Worker | 1200 Savannah Chase Cir, Apt 304, Garner, NC 27529-5217 | 2007-05-09 |
| 1154399723 | Lisa Ann Moran | Psychiatry & Neurology | 2225 Challenger Way, Santa Rosa, CA 95407-5441 | 2006-03-09 |
| 1558860320 | Lisa Marie Moran | Speech-Language Pathologist | 270 Pierce St Ste 302, Kingston, PA 18704-5141 | 2018-02-07 |
| 1386030963 | Lisa Moran | Clinical Neuropsychologist | 9968 Hibert St Ste 105, San Diego, CA 92131 | 2015-04-10 |
| 1235262015 | Lisa Marie Moran | Speech-Language Pathologist | 200 Governors Ave, Medford, MA 02155-1644 | 2007-03-13 |
| Street Address |
360 STATION DR STE 120 |
| City | CRYSTAL LAKE |
| State | IL |
| Zip Code | 60014-7994 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497394720 | Lorelei Mariano | Physical Therapist | 350 E Congress Parkway Ste A, Crystal Lake, IL 60014 | 2020-01-03 |
| 1396227070 | Behavioral Services for Autism, Inc | Behavioral Analyst | 1095 Pingree Road, Suite 204, Crystal Lake, IL 60014 | 2018-08-30 |
| 1831635564 | Isis Mendoza-garnica | Counselor | 6803 Rose Ave, Crystal Lake, IL 60014 | 2017-01-19 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1306394051 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 177 W Virginia Street, Crystal Lake, IL 60014 | 2016-09-12 |
| 1124492830 | Align Spine & Orthopaedics | Durable Medical Equipment & Medical Supplies | 60 B West Terra Cotta Ave, #265, Crystal Lake, IL 60014 | 2015-11-18 |
| 1558747428 | Shabana Nawaz | Optometrist | 4777 Northwest Highway, Crystal Lake, IL 60014 | 2015-08-03 |
| 1548649205 | Daniel Okon | Social Worker | 304 Charllote Ave, Crystal Lake, IL 60014 | 2015-05-27 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1558763581 | Brooke Nicole Grandt | Occupational Therapist | 394 Heisler Ct, Crystal Lake, IL 60014 | 2014-09-22 |
| Find all providers in zip 60014 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407348337 | Brenda Neshell Sims | Nurse Practitioner | 741 S Mchenry Ave Ste C-d, Crystal Lake, IL 60014-7445 | 2018-06-06 |
| 1154729838 | Crystal Lake Center for Chronic Pain Sc | Nurse Practitioner | 1 South Northwest Highway, Crystal Lake, IL 60014 | 2014-12-12 |
| 1972909877 | Jessica Pawlicki | Nurse Practitioner | 820 E Terra Cotta Ave Ste 132, Crystal Lake, IL 60014-3655 | 2014-11-05 |
| 1558668764 | Gina C Chmela | Nurse Practitioner | 145 S. Virginia Street, Crystal Lake, IL 60014-7226 | 2011-02-24 |
| 1003815770 | Sandra Jaeschke | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014-7978 | 2005-07-15 |
| 1114568367 | Candace Joy Esposito | Nurse Practitioner | 750 E Terra Cotta Ave Ste A, Crystal Lake, IL 60014-3621 | 2019-09-30 |
| 1134784861 | Linda Kramer | Nurse Practitioner | 500 Coventry Ln, Crystal Lake, IL 60014-7579 | 2019-05-08 |
| 1609310259 | Anna Kastanas | Nurse Practitioner | 1 S Virginia St, Crystal Lake, IL 60014-5828 | 2016-12-15 |
| 1730632407 | Joanna Hutson | Nurse Practitioner | 390 E Congress Pkwy, Suite C, Crystal Lake, IL 60014-6202 | 2016-07-29 |
| 1285099622 | Juliana Gonzales-hannon | Nurse Practitioner | 360 Station Dr, Crystal Lake, IL 60014 | 2015-12-30 |
| Find all providers in CRYSTAL LAKE | ||||
| City | CRYSTAL LAKE |
| Zip Code | 60014 |
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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.