Individual ProviderLisa FortmanFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address911 N Elm St, Suite 301, Hinsdale, IL 60521-3634(630) 986-1420(630) 856-6865PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Fortman is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1225095565Provider TypeIndividualFull NameFortman, LisaTitleMrs.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/28/2006Last Updated3/16/2021Contact InformationPractice LocationPractice Address911 N Elm St, Suite 301, Hinsdale, IL 60521-3634Phone(630) 986-1420Fax(630) 986-9172Mailing LocationMailing Address911 N Elm St, Suite 301, Hinsdale, IL 60521-3634Phone(630) 856-6865Fax(630) 856-6813Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicenseI36083565Illinois