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Individual provider Active NPI

Lauren Vassiliades

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1023503885
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036163732 Issued in IL
Practice address
250 E Superior St Ste 4-2304
Chicago, IL 60611-2914
Phone
(312) 695-5753
Fax
(312) 695-5645
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125072810 IL
Diagnostic Radiology Physician 2085R0202X 036163732 IL Primary

Addresses

Primary practice location

250 E Superior St Ste 4-2304
Chicago, IL 60611-2914

Mailing address

Weiss Memorial Hospital, Medical Education DPT.
4646 N. Marine Drive, C Elevators, 7TH FLR. # 7100
Chicago, IL 60640
Phone (773) 564-5225

Other practice location 1

Weiss Memorial Hospital, Medical Education Dpt.
4646 N. Marine Drive, C Elevators, 7th Flr. # 7100
Chicago, IL 60640
Phone (773) 564-5225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230730000170 IL Practitioner - Diagnostic Radiology 8325372568 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-8372

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036163732ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Jun 1, 2024 Accepting new patients
Loyola University Medical Center CurrentSince Jun 1, 2024 Accepting new patients
Central Dupage Physician Group Internal Medicine PastSince Nov 5, 2023 Accepting new patients

Locations

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

Organizations & group practices 3

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1023503885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WEISS MEMORIAL HOSPITAL, MEDICAL EDUCATION DPT.",
            "address_2": "4646 N. MARINE DRIVE, C ELEVATORS, 7TH FLR. # 7100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60640",
            "telephone_number": "773-564-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E SUPERIOR ST STE 4-2304",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112914",
            "telephone_number": "312-695-5753",
            "fax_number": "312-695-5645"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Weiss Memorial Hospital, Medical Education Dpt.",
            "address_2": "4646 N. Marine Drive, C Elevators, 7th Flr. # 7100",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60640",
            "country_code": "US",
            "telephone_number": "773-564-5225",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VASSILIADES",
        "first_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125072810",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036163732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.