Individual provider Active NPI

Lauren Ellen Skalitzky, PA-C

  • Surgical Physician Assistant
  • Chicago, IL
National Provider Identifier
1043696180
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
085.006244 Issued in IL
Practice address
676 N Saint Clair St Ste 650
Chicago, IL 60611-2929
Phone
(630) 802-6797
NPI assigned
Jul 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X IN PROCESS MA
Surgical Physician Assistant 363AS0400X 085.006244 IL Primary

Addresses

Primary practice location

676 N Saint Clair St Ste 650
Chicago, IL 60611-2929

Mailing address

676 N Saint Clair St Ste 650
Chicago, IL 60611-2929

Other practice location 1

55 Fruit St
Yawkey 7B
Boston, MA 02114-2621
Phone (617) 726-5507

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
I20170914002636 IL Practitioner - Physician Assistant 7618276932 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

171 N Aberdeen St
Suite 100
Chicago, IL 60607-1669
Phone (312) 926-4150

251 E Huron
Chicago, IL 60611-2908

251 E Huron St
Chicago, IL 60611-2908

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

635 N Dearborn St
Chicago, IL 60654-4618
Phone (312) 926-0404

636 Raymond Dr
Suite 107
Naperville, IL 60563-9789
Phone (630) 416-2300

660 N Westmoreland Rd
302 Lake Forest OBGYN
Lake Forest, IL 60045-1673
Phone (312) 926-6146

675 N Saint Clair St
Chicago, IL 60611-5975

675 N St Clair
Chicago, IL 60611-5975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
IN PROCESSMAMDAcupuncturist
085.006244ILMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Aug 28, 2017 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Aug 28, 2017 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

675 N Saint Clair St
Ste 21700
Chicago, IL 60611

676 N Saint Clair St
Ste 650
Chicago, IL 60611
Phone (312) 695-3800

250 E Superior St
Ste 5520
Chicago, IL 60611

1000 N Westmoreland Rd
Lake Forest, IL 60045
Phone (847) 535-6150

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

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 4

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1043696180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112929",
            "telephone_number": "630-802-6797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fruit St",
            "address_2": "Yawkey 7B",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021142621",
            "country_code": "US",
            "telephone_number": "617-726-5507",
            "fax_number": "617-724-3895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SKALITZKY",
        "first_name": "LAUREN",
        "middle_name": "ELLEN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "IN PROCESS",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "IL",
            "license": "085.006244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.