Individual provider Active NPI

Lindsay J McCracken, P.A.-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1003956640
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085002744 Issued in IL
Practice address
3860 W Ogden Ave
Chicago, IL 60623-2460
Phone
(872) 588-3000
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-002744 IL
Physician Assistant 363A00000X 085002744 IL Primary

Addresses

Primary practice location

3860 W Ogden Ave
Chicago, IL 60623-2460

Mailing address

3860 W Ogden Ave
Chicago, IL 60623-2460
Phone (872) 588-3000

Other identifiers 3

IdentifierTypeStateIssuer
085002744OtherILSTATE LICENSE
385001585OtherILCS LICENSE
1072634OtherILSPECIALTY BOARDS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160823001490 IL Practitioner - Physician Assistant 4486949963 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
085-002744ILMDPhysician Assistant
085002744ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lawndale Christian Health Center CurrentSince Jul 19, 2016 Accepting new patients
Lawndale Christian Health Center CurrentSince Jul 19, 2016 Accepting new patients
Lawndale Christian Health Center Current Accepting new patients
Northwest Pediatric Services, S.C. PastSince Dec 2, 1994 Accepting new patients

Locations

3860 W Ogden Ave
Chicago, IL 60623
Phone (872) 588-3000

4696 Paysphere Cir
Chicago, IL 60674

Interoperability endpoints

  • Direct secure messaging: lmccracken690926@direct.ochin.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1003956640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232460",
            "telephone_number": "872-588-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCRACKEN",
        "first_name": "LINDSAY",
        "middle_name": "J",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2023-03-07",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002744",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085002744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "085002744",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CS LICENSE",
            "identifier": "385001585",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY BOARDS",
            "identifier": "1072634",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.