DR. TREVOR WARREN LISSOOS M.D. NPI 1700864337

NPI Information

  • NPI: 1700864337
  • Provider Name: DR. TREVOR WARREN LISSOOS, M.D.
  • Classification: Specialist - 174400000X
  • Entity Type: Individual
  • Address: 1475 E BELVIDERE RD
    SUITE 301
    GRAYSLAKE, IL
    ZIP 60030
  • Phone: (847) 295-0013

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NPI Details

DR. Trevor Warren Lissoos, M.D. is a specialist in Grayslake, IL. The provider is 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. DR. Trevor Warren Lissoos, M.D. NPI is 1700864337. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1475 E BELVIDERE RD
SUITE 301
GRAYSLAKE, IL
ZIP 60030-012
Phone: (847) 295-0013
Fax: (847) 295-1574

The enumeration date for this NPI number is 1/4/2006 and was last updated on 6/18/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1F54679MEDICARE UPINILLINOIS
2L83881MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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