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DR. LISA C. MAZZULLO M.D.
NPI 1952354342
Specialist in Chicago, IL

Active since May 18, 2006Opted out of Medicare · through May 22, 2027
737 N MICHIGAN AVE, SUITE 950, CHICAGO, IL 60611(312) 751-7515(312) 751-1208 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Lisa C. Mazzullo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. LISA C. MAZZULLO M.D. (NPI 1952354342) is an individual specialist in Chicago, Illinois and active in the NPI registry since May 2006. She has opted out of Medicare through May 22, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1952354342
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameDR. LISA C. MAZZULLOCredential: M.D.
Location Address737 N MICHIGAN AVE, SUITE 950Chicago, IL 60611-2615
Mailing Address55 W Delaware Pl, Unit 907Chicago, IL 60610-3360 · (312) 751-7515 · Fax (312) 751-1208
Phone(312) 751-7515
Fax(312) 751-1208
Sole ProprietorNo
Enumeration DateMay 18, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1952354342 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
737 N MICHIGAN AVE, Chicago, IL 60611
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Other Identifiers 1

Medicare UPING13879IL

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Lisa C. Mazzullo M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 22, 2017 through May 22, 2027.

Opt-Out Effective DateMay 22, 2017
Opt-Out In Effect ThroughMay 22, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PSYCHIATRIC ASSOCIATES SC
Psychiatry & Neurology (Psychiatry)
737 N MICHIGAN AVE, SUITE 1200
CHICAGO, IL 60611
Cook County (312) 373-7300
DR. IAN MURPHY
General Acute Care Hospital (Critical Access)
737 N MICHIGAN AVE, SUITE 1600, CARDIOVASCULAR IMAGING
CHICAGO, IL 60611
Cook County (312) 926-2000
ORTHODONTICS FOR ALL AGES, P.C.
Dentist (Orthodontics and Dentofacial Orthopedics)
737 N MICHIGAN AVE, SUITE 1330
CHICAGO, IL 60611
Cook County (312) 266-7118
DR. WILIIAM DONALD CIGANEK M.D.
Psychiatry & Neurology (Psychiatry)
737 N MICHIGAN AVE, SUITE 2240
CHICAGO, IL 60611
Cook County (312) 255-0140
AMY MARIE YOUNG MS, OTR/L, CHT
Occupational Therapist (Hand)
737 N MICHIGAN AVE, SUITE 700
CHICAGO, IL 60611
Cook County (312) 337-6960
JUDITH LICHTENSTEIN, MD, S.C.
Psychoanalyst
737 N MICHIGAN AVE, #2240
CHICAGO, IL 60611
Cook County (312) 944-1701
MRS. BARBARA LEE HARTNETT MS,NP
Nurse Practitioner (Obstetrics & Gynecology)
737 N MICHIGAN AVE
CHICAGO, IL 60611
Cook County (312) 440-3810
THOMAS A WIEDRICH MD
Orthopaedic Surgery (Hand Surgery)
737 N MICHIGAN AVE, STE 700
CHICAGO, IL 60611
Cook County (312) 337-6960

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Mazzullo's NPI number?

The NPI number for Lisa Mazzullo is 1952354342. It was assigned to this individual provider in the NPPES registry on May 18, 2006.

Where is Lisa Mazzullo located?

Lisa Mazzullo practices at 737 N Michigan Ave Suite 950, Chicago, IL 60611. The listed phone number is (312) 751-7515.

What is Lisa Mazzullo's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Lisa Mazzullo enrolled in Medicare?

No. Lisa Mazzullo has opted out of Medicare through May 22, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Lisa Mazzullo was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.