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1760524722

NPI Code Detail

MEDICARE: LISA A TAITSMAN MD

MEDICARE: LISA A TAITSMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0801X	Orthopaedic Trauma Physician	MD00040103	WA
2	207X00000X	Orthopaedic Surgery Physician	036178296	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200042544	OTHER	WA	RAIL ROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0232023	OTHER	WA	L&I
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760524722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA A TAITSMAN MD

Provider Business Mailing Address
First Line	:	150 HARVESTER DR STE 300
Second Line	:
City	:	BURR RIDGE
State	:	IL
Zip	:	60527-5965
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5841 S MARYLAND AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-1443
Country	:	US
Telephone Number	:	888-824-0200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	03/23/2026

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Directions to “ LISA A TAITSMAN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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