Individual ProviderLisa HolmesFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address911 N Elm St, Ste 123, Hinsdale, IL 60521-3634(630) 325-5709PECOS EnrollmentBased on the most recent information from CMS, provider Lisa Holmes 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 ID1871550798Provider TypeIndividualFull NameHolmes, LisaTitleMrs.CredentialMDGenderFemaleSole ProprietorNoEnumeration Date4/26/2006Last Updated3/18/2021Contact InformationPractice LocationPractice Address911 N Elm St, Ste 123, Hinsdale, IL 60521-3634Phone(630) 325-5709Fax(630) 325-0388Mailing LocationMailing Address911 N Elm St, Ste 123, Hinsdale, IL 60521-3634Phone(630) 325-5709Fax(630) 325-0388Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense36075938IllinoisProvider IdentifiersIDDescriptionIssuerID400280DescriptionOtherIssuerMEDICARE GROUP NUMBERIllinoisID036075938DescriptionMedicaidIssuerUnlistedIllinois